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Wisconsin Department of Commerce SOIL AND SITE EVALUATION <br /> Division of Safety and Buildings Page-L—of <br /> Bureau of Integrated Services in accordance with s. ILHR 83.09, Wis. Adm. Code <br /> Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must County <br /> include,but not limited to: vertical and horizontal reference point(BM),direction and BuieAler <br /> percent slope,scale or dimensions,north arrow,and location and distance to nearest road. 131rcel I.D.# <br /> 6z8 4o8 Boz. <br /> APPLICANT INFORMATION- Please print all information. Reviewed by Date <br /> Personal information you provide may be used for secondary purposes(Privacy Law,s.15.04(1)(m)). ." <br /> Property Owner Property Location <br /> 'R Govt.Lot fo 1/4 1/4,ST46 ,N,R ` E(oie <br /> Properfy Owner's Mailing Address Lot# Block# Subd.Name or CSM# <br /> 1108 Tl ERLINt; SPUR z• Va- /s P. 97 <br /> City State Zip Code Phone Number ❑ City ❑ Village XT Town Nearest Road <br /> ItjaE-rt)I X a s .� 1�5qj.g2gr s Wr CD RP. A <br /> New Construction Use: AwResidentiall/Number of bedrooms Addition to existing.buirdin� <br /> Replacement ,^t,r ❑Public or commercial-Describe: <br /> g <br /> Code derived daily flow ` / gpd Recommended design loading rate •5 bed,gpd/f?. trench,gpd/f12 <br /> Absorption area required bed,ft2 , 0 trench,ft2 Maximum design loading rate S bed,gpd/ftz• �O trench,gpd/ft2 <br /> Recommended infiltration surface elevation(s) 17. 4 ft(as referred to site plan benchmark) <br /> Additional design/site considerations ',sA <br /> Parent material GLACIAL CIPr Flood plain elevation,if applicable Nft <br /> S = Suitable for system Conventional �cM�tound In-Ground Pressure AT-Grade System in Fill Holding Tank <br /> U = Unsuitable for system ❑ S �U 5 S ❑ U ❑ S � U El U El ;qU ❑ S J4 U <br /> SOIL DESCRIPTION REPORT <br /> Boring# Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft2 <br /> in. Munsell Qu.Sz.Cont.Color Gr.Sz.Sh. Bed Trench <br /> -4 s ile 3 2. �� s 1 2 ce .S • 6 <br /> Z 7 AW Gt Ze.o •S ' <br /> Ground 3 v!► 4 s L H f A NO NI° <br /> elft. `� 7- 7_49R 4A TJ00 44 s C4 <br /> Depth to <br /> limiting n f tf to <br /> in. <br /> Remarks: <br /> Boring# <br /> z -Z7 YUCIA 414 �—� f •S •6 <br /> 3 <br /> Ground b ,C •s- <br /> 6 <br /> Depth to <br /> limiting <br /> factor <br /> 2:7-in. Remarks: <br /> CST Name (Please Print) Signature Telephone No. <br /> • S". S <br /> Ad6ress Date CST Number <br /> Z'17`0 >1�w 35 rssr>r Z- I B-9g 2 2 5&5I <br />