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Wisconsin Department of Commerce SOIL EVALUATION REPORT Page�_of 3 <br /> Division of Safety and Buildings <br /> in accordance with Comm 85,Wis. Adm. Code <br /> corurry (�w r n 2)`t <br /> Attach complete site plan on paper not less than 81/2 x 11 inches in size.Plan must <br /> include,but not limited to:vertical and horizontal reference point(BM),direction and Parcel I.D. <br /> percent slope,scale or dimensions,north arrow,and location and distance to nearest road. O J,- 4 il.13- OI S00 <br /> Please print all information. Reviewed Date <br /> Personal information you provide may be used for secondary purposes(Privacy Law,s.15.04(1)(m)). 03 <br /> Property Owner Property Location <br /> /T n n - NArt sen Govt.Lot -49 1/4 /t/1~1/4 S 13 T vo N R 1r E(or <br /> Property Owner's Mailing Address Lot# BID&# Subd.Name or CSM# <br /> i/3J Rosc P/ace <br /> City State Zip Code Phone Number ❑City ❑Village OTown Nearest Road <br /> Roseville MN. I SS'/1GnLd -e,. Rol <br /> ❑ New Construction Use:® Residential/Number of bedrooms Code derived design flow rate 3,10 GPD <br /> ❑Replacement ❑ Public or commercial-Describe: <br /> Parent material GIaLc(CL ( D.^i tit Flood Plain elevation if applicable A114 ft <br /> General convnents r,1,d pYr 704 <br /> and recommendations: 0% ( ? 8q„7 <br /> lower g9 � <br /> F Boring# Boring 9� <br /> © Pit Ground surface elev._—_ft. Depth to limiting factor �70 in. <br /> Soil Application Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF <br /> in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. 'Eff#1 'Eft#2 <br /> / o.y 7.SyR3/� !S /'156/e rt ( c5 OLco I , 7 /. d <br /> 7.S17? "lq ok'"Ss/e m G S at 4co 5' S <br /> y3- 7G 7•5-YR % -- {S 3r"sbk tea`- <br /> ® Boring# ❑ Boring <br /> © pit Ground surface elev. R. Depth to limiting factor > 7� in. <br /> Soil Application Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDtfF <br /> in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. 'Eff#1 'Eff#2 <br /> I 6-y 7•S Y/t 3�,f �S /n+Sli ,,, i GS CO .7 J, <br /> `I- 96 7srrR y/ 'S 01 M.Sh/c kn 1 6S ACO s' <br /> ere-7V 7•Sl-/l% - {s d.,.,s d k M I 65 <br /> Effluent#1 =BOD >30:!220 mg/L and TSS>30:E 150 mg/L 'Effluent#2=BOD,:E 30 mg/L and TSS<30 ng1L <br /> CST Name(Please Print) Signature CST Number <br /> Ofilwrs S. Qarol t?�S S 73 ly d`0" <br /> Address VDate Evaluation Conducted Telephone Number <br /> ,4776U HwX 35- web-51e,- wS5-99'53 9-7-0 3 7ir- C4,G-Yis7 <br />