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_ Wiscshsin Department of Industry, SOIL AND SITE EVALUATION REPORT. Page_L of 3 <br /> ' Labtr arid Human Relations <br /> Division of Safety&Buildings in accord with ILHR 83.05,Wis.Adm. Code <br /> COUNTY <br /> •Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include,but �"`'Y'n e <br /> dc <br /> not limited to vertical and horizontal reference point(BM),direction and%of slope,scale or PARCEL I.JZ# <br /> dimensioned,.north arrow,and location and distance to nearest road. Oy'S r -� -\'.`(37) <br /> APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REVIEWED BYDTE <br /> t �� 6 fa.- <br /> PROPERTY OWNER: aNGADDRESS <br /> PROPERTY LOCATION <br /> Elle.,y v► o✓q,�►SK, GOVT.LOT zt�)1!4 �J1/4,S i5 T 39 N,R 14 Fes)W <br /> PROPER 0 ER':S LOT# BLOCK# SUBD.NAME OR CSM# <br /> Cowy.Ay-ed. 4 ,a <br /> CITY,STATE ZIP CODE PHONE NUMBER ['CITY ['VILLAGE 'MOWN NEAREST ROAD •' <br /> f eoner v3% 5''f$O1 ( )(,35-x l-2..- -2 1 d t <br /> K OAK i -1 <br /> D4 New Construction Use pa Residential/Number of bedrooms 3 1 1 Addition to existing building ,,__ <br /> j I Replacement [ ] Public or commercial describe <br /> Code derived daily flow 45o gpd Recommended design loading rate . 1 bed,gpd/ft2 .8 trench,gpd/ft2 <br /> Absorption area required (,43 bed,ft2 5/.3 trench,ft2 Maximum design loading rate • 7 bed,gpd/ft2 •8 trench,gpd/ft2 <br /> Recommended infiltration surfaceelevation(s) 5'5.$' (ALT 74:3') ft (as referred to site plan benchmark) <br /> Additional design/site considerations A 'm E.Je.j: t oo.o C Top of 5)4"T.P. Z 46*% si,D?&S <br /> Parent material 314 NAL, d2.; - ' Flood plain elevation,if applicable ', ft <br /> S=Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK <br /> U=Unsuitable for system EIS ❑U ®S ❑U ®S ❑U ®S 0 0 211.1 El EIU <br /> SOIL DESCRIPTION REPORT <br /> Depth Dominant Color Mottles Texture Structure Consistence Bou Roots GPD/ft2 <br /> Boring# Horizon in. Munsell Qu.Sz.Cont.Color DD Gr. Sz. Sh. Y Bed Trench <br /> ' ' I 4-" 7.5 Y rZ 3/2- /nrr„a, .P-4) • '7 S <br /> gismo <br /> z 4-18 7.s'' . 414 --n e-ne 4J , 7 . 8 <br /> Ground <br /> elev. . <br /> 98•loft. <br /> Depth to <br /> limiting <br /> factor <br /> 9a.1 <br /> 1g" <br /> Remarks: C2•44.4,-‘) <br /> Boring# <br /> 1P 1..." 7 SYR.• 512. --Igo-y.0e ,22/ I44 / "1Q ez4.2 3.4 . '7 Fe <br /> "` `' 2. `-4/ 1.6YR-`/4' -.- e , ) �q,,.55 /-7-n_2_, ev �� . 7 : 8 <br /> :Ground -3 *T-51 -r.SYR i)t ..-au,-,...e6 v 1c) I r►,sg ,'-v�r C4' I./>C • '7 - S <br /> `leo. ft. 4 SI-84 i•5YW-Aj4 �,p-n,2 U A 61401 r+• ..0 -- l.r f -. . g <br /> 8.Depth to <br /> limiting <br /> factor <br /> 9t. 3' <br /> c. <br /> B Remarks: T M & K A �cta� 'A'�''S `o <br /> CST Name.—Please Print SEPTIC & EXCAVATION Phone: <br /> Address: MCR 59, BOX 478d <br /> Signature: 4_hie. SPOCR6r, WI 54801 Date: CST Number: <br /> (7155) -7482 G/ '1' /s'366`3 <br />