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Wisconsin Department of Safety and Professional services Pale I ofDivisionotindustryServices (_� l' co <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 11 inches in size. Plan must include, <br />but not limited to: vertical and horizontal reference point (BM), direction and percent slope, Parcel I.D. <br />scale or dimensions, north arrow, and location and distance to nearest road. <br />Please print all information. Reviewed by , /t Date <br />Personal information you provide may be used for secondary purposes Priva Law, s. 15.04 1 m . �" // V ` • �'Z' 9 <br />Property Owner Property L tion <br />--TO 7A M r I Govt. Lot Y. -� W% S + T3 ? N R E (or) W <br />Property Owner's Mailing Address Lot # Block # Subd. Name or <br />L C M i/ <br />City St, Zip Code Phone Number p city ❑ vie Yon Nearest Road <br />j,l <br />New Construction Use: 0 Residential/ Numberofbedrooms : Code derived design flow rate GPD <br />Replacement ❑ Pubiic or commercial — Describe: <br />Parent material ) I �i r--i� Flood Plan elevation if applicable Atft. <br />General comments and nacommendatrons: <br />Boring # <br />j Boring <br />�j Pit Ground surface efev. <br />Depth to limiting factor>_5'(Tn. <br />Horizon <br />Depth <br />In. <br />Dominant Color <br />Munseil <br />Redox Description <br />Qu. Az. Co t. Color <br />Texture <br />Structure <br />Gr. Sz. Sh. <br />Consistence <br />Boundary <br />Roots <br />I.VQt.Y!4 "Qm <br />GPD/Fe <br />"Eff#1 <br />"Eff#2 <br />` <br />r . <br />141 <br />VF1 <br />1- <br />_ <br />T <br />75 <br />f� <br />_ <br />Z j Boring # <br />Boring �-7� <br />Pit Ground surface elev / (C Depth to limiting factor S % in. <br />• i. <br />�.0.•1 <br />Dominant ColorRedox <br />Munsell <br />Description <br />Cont. Color <br />. ♦ • . <br />' i.� <br />ri4i��.�d+737?-fFigtliKlti-� <br />���. <br />wo <br />CST am <br />ga <br />e6v en L ano l J > Ju 5 75u m /L <br />CST <br />r <br />Address <br />Date Evaluation Cond <br />Telephone Nurritwr <br />