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Wisconsin Department of Safety and Professional Services G� _ 1� �� Page of 3 <br />Division of Industry Services <br />SOIL EVALUATION REPORT <br />In accordance with SPS 385, Wis. Adm. Code County <br />Attach complete site plan on paper not less than 8 1/2 x 19 inches in size. Plan must include, &_' <br />but not limited to: vertical and horizontal reference point (BM), direction and percent slope, Parcel I.D. C <br />scale or dimensions, north arrow, and location and distance to nearest road. Z T. i3�G <br />00 <br />Please Print all information. Reviewed by , , n Date <br />Property Owner Property Location ❑ <br />rM 6 "4-d r lJ Govt. Lot n/ 6 Y-gZ//< S 3 T i-I N R E (or) W <br />Property Owner's Mailing Add ss Lot # Block # Subd. Name or CSM# <br />City. State 1 Zip Code Phone Number ❑ City Village Town l Nearest Road 1 — <br />�/1( " '... e_ .._1 M/I/I ' /_fit _ n i <br />New Construction Use: ❑ Residential/ Numberofbedrooms _ Code derived design flow rate PD , <br />❑ Replacement ® Public or commerce — Describe: <br />Parent material ( I ) r <br />Flood Plan elevation if applicable �ft. <br />General comments and recommendations: <br />MBoring # <br />❑ Boring 7� <br />wPit Ground surface elev. <br />Depth to limiting factor,�eg2 <br />• <br />�-. <br />�. • . <br />Redox Description <br />:• ._ <br />^•. <br />NMI <br />Boring # <br />Boring 27-a <br />SS <br />Pit Ground surface elev. . Depth to limiting factory in. <br />Horizon <br />Depth <br />In. <br />Dominant Color <br />Munsell <br />Redox Description <br />. Qu. Az. Cont. Color <br />Texture <br />Structure <br />Gr. Sz. Sh. <br />Consistence <br />Boundary <br />Roots <br />oou.RPPucauon Kate <br />GPD/Ft2 <br />"Eff#1 <br />*Eff#2 <br />11-214 <br />L <br />Z <br />S <br />- <br />LF <br />`Fffijpnt#1 <br />aRr)r] -qn<"n <br />"A Tcc�-an�ecn <br />CS Name (Ple a Print) <br />Signatu <br />P av .^a "V ML ano a J5 > M 5 15U m 1L <br />CST tLumber <br />Address <br />DeaeEval <br />tion onducted <br />Telephone Number <br />-,-, <br />