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Wisconsin Department of Commerce SOIL EVALUATION REPORT Page/of—! . <br /> Division of Safety and Buildings <br /> in accordance with Comm 85,Wis. Adm. Code County <br /> Attach complete site plan on paper not less than 8112 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. OZO <br /> Date <br /> b Reviewed y <br /> Please print all Information. Re a ram,/ <br /> Personal information you provide may be used for secondary purposes(Privacy Law,s.15.04(1)(m)). <br /> Property Owner Property Location <br /> v�r �N <br /> GovL Lot 1/4 114 SZ°1 T kC N R 16 E(or JN <br /> PropertyOwner's Mailing Address Lot# I Block# Subd.Name or CSM# <br /> City State Zip Code Phone Number ❑City []Village Co Town Nearest Road <br /> -J; 15-#M 3 1 2 )866 .8�55- i(; ,x,( Il r NL <br /> New Construction Use: Residential/Number of bedrooms - Code derived design flow rate 100 GPD <br /> ❑Replacement ❑ Public or commercial-Describe: <br /> Il _ Flood Plain elevation if applicable A111L ft. <br /> Parent material 6((�6 bf <br /> General comments <br /> and recommendations: <br /> q 1, <br /> ❑ Boring cy <br /> MBoring# /(�6 ft. Depth to limiting factor in. <br /> ® pit Ground surface elev. Soil Application Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDff <br /> in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. '01#1 'Eff#2 <br /> 9- 0 7,50CYZ —1— 1-5 /4,66 k ZIn , 7 l-e' <br /> l 0 75-tq Y3 KZe- ! L 6S -7 6 <br /> o -36 7.5 e GZd S S< OS mL 65 ilf= <br /> F2_1 Boring# ❑ Boring <br /> 51 Pit Ground surface elev. 90 ft. Depth to limiting factor in• Soil Application Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDfftr <br /> in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. 'EtF#1I 'Eff#2 <br /> 7 <br /> ?o r� / �2 S/ n-i1 65 /tl 6 <br /> Effluent#1 -BOD >30<220 mgfL and TSS>30 1150 mglL 'Effluent#2=BOD <30 mglL and TSS!j 30 mglL <br /> CST an*(per per) Pignature CST Number <br /> Tellw�,der �"!�s` <br /> Address Date Evaluation Conducted Telephone Number <br /> 27760 Wei 7i5- <br />