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Wisconsin Department of Commerce SOIL AND SITE EVALUATION <br /> Division of Salsty and Buildings Page of <br /> Qureau of Integrated Services in accordance with s. ILHR 83.09,Wis.Adm. Code <br /> Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must County <br /> Include,but not limited to: vertical and horizontal reference point(BM),direction and Y2 U 1Z <br /> percent slope,scale or dimensions,north arrow,and location and distance to nearest road. P&rcei I.D.# <br /> APPLICANT INFORMATION-Please print all information. Reviewed by Data <br /> Personal kftffnation you provide may be used for setxndary purposes(Privacy Law,s.15.04(1)(m)). <br /> Property Owner Property Location <br /> GovL Lot 1/4�L 1/4,S fs T40 'N,R if E(or8 <br /> Prooerty Owner's Mailing Adtlress Lot# Block# I Subd.Name or CSM# <br /> 2SS 73 Rc4i ,f,SLA0P Lx- DR - 40 ACRE5 <br /> City State Zip Code Phone Number ❑ City ❑ village ® Town Nearest Road <br /> Rt4131A i 3o Ic his )259- 959 Co . RD A <br /> New Construction Use: 14 Residential/Number of bedrooms 3 Addition to existing building <br /> ❑ Replacement ,( El Public or commercial-Describe: —1 <br /> Code derived daily flow `60 _gpd Recommended design loading rate • bed,gpd* J—trench,gpcL* <br /> Absorption area required ftz 2bed4 <br /> Maximum design loading rate_.___bed.WI* -g trarich,gpd/(tz <br /> Recommended infiltration surface elevations) 9S 3 A� 95 0 ft(as referred to site plan benchmark) <br /> Additional design/site considerations <br /> Parent material 1 rte(, CIAL WIPE Flood plain elevation,if applicable ft <br /> S = Suitable for system Conventional Mound In-Ground Pressure I AT-GradeSystem in Fill Holding Tank <br /> U = Unsuitable for system s ❑ u W s ❑ u MS ❑ u i�s ❑ u IYl s ❑ U ❑s to U <br /> SOIL DESCRIPTION REPORT <br /> Boring# Horizon Depth Dominant Color Mottles Texture Stnicdire Consistence Boundary Roots GPD/t12 <br /> in. Munsell Qu.Sz.Cont.Color Gr.Sz.Sh. Bed ,Trench <br /> ( I O 7 W Z - `- is 0. / CS -'VI- . -7 B <br /> Ground <br /> elev. <br /> �ft. <br /> Depth to <br /> limiting <br /> f�a/cc1t/9or <br /> >JCLfz—in. <br /> Remarks: <br /> Boring# <br /> ( 9 75W-3/:Z <br /> tis , <br /> Ground <br /> elrevv <br /> i•a ft. <br /> Depth to <br /> limiting <br /> AlAl <br /> n. Remarks: 94AID Alit" �f)KNfG <br /> CST Name (Please Print) Signature Telephone No. <br /> dc�fA.2n s4,6 - 415 <br /> Addtess Date CST Number <br /> 2-77&0 3S 4-13 - 9S 36 0 <br />