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Wisconsin Department of Commerce SOIL EVALUATION REPORT Page / of 7 <br /> Division of Safety and Buildings <br /> in accordance with Comm 85,Wis. Adm. Code <br /> L�u rn e <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 Parcel I.D. <br /> percent slope,scale or dimensions•north arrow,and location and distance to nearest road. <br /> Please print all information. Reviewed by Date '/ <br /> Personal information you provide may be used for secondary purposes(Privacy Low,s.15.04(1)(m)). 1/ -Oy—v!s <br /> Property Owner Property Location <br /> /'�r/ti e Pdpe— Govt Lot SW 1/4 5"14 S 34T y0 N R /S E(orX0 <br /> Property Owners Mailing Address Lot# Block# Subd.Name or CSM# <br /> S3 W Co. ?d /4 <br /> City State Zip Code Phone Number ❑City ❑Village ®Town Nearest Road <br /> W e65 fer WS I s'r/pg. >/S') "- gy 8/ Jsc.k5-- Co Por /� <br /> New Construction Use:❑ Residential/Number of bedrooms Code delved design flow rate GPD <br /> ❑Replacement ® Public or commercial-Describe: OFFre a e.SAog <br /> Parent material Flood Plain elevation if applicable N//9 ft. <br /> General commentsref (pnro on- 3i/''C <br /> and recommendations: SI s le✓ 9�S itJe M rtes 06ST ru ese• <br /> e(�/?4,,(e COMM 8S 30 W r3) <br /> Boring# ❑ Boring <br /> Pit Ground surface elev. 9719 ft. Depth to limiting factor in. <br /> Soil Application Rate <br /> Horizon Depth Domdnam Color Redox Description Texture Structure Consistence Boundary Roots GPDtfF <br /> in. Munsell Qu.Sz. Cont Color Gr.Sz.Sh. •Eff#1 •Eff#2 <br /> o -44 7.X YR3/A — /S /ms6k yri l GS 3 • 7 /.6 <br /> Y- J• 7-SYR 41 /S /,"_f 6,k rrr l 4s ' AM . 7 /. 6 <br /> 3 M"I'A SYR y/3 C dmmAk Mtf! cs 'kM . J, , 3 <br /> 7.51'R q'i <br /> with %p° /jwnols /FS df/�'r/Y <br /> Boring# ❑ Boring <br /> ® Pit Ground surfaceelev. 97.0 ft. Depth to limiting factor 1 /0.T in. <br /> Scil Application Rate <br /> Horizon Depth Dominant Color Redoxl,Description Texture Structure Consistence Boundary Roots GPD/fF <br /> In. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. •Eff#1 •Eft#2 <br /> l o- H 7.S- rR31d. /S /Msbk t' I e-5 3F 7 1. 6 <br /> of W-36 7.SYR y/9 /S /, s6rt r 1 65 J•m .7 116 <br /> .3 G-S"t 5FR '1G XM41'11- f" e- 5 J n AAW "AW <br /> Effluent#1 =BOD >30:5 220 mg&and TSS>30<150 n91L 'Ellluent#2=BOD a 30 mglL and TSS<30 mglL <br /> CST Name(Please Print) — — Signature J CST Number <br /> JAM es s. Dani c is U 7341 <br /> Address V Date Evaluation Conducted Telephone Number <br /> ot 7764 /Yr, �s webs>`p, w1 s485'� /0--/9 &-yrs? <br />