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Wisconsin Department of commerce SOIL EVALUATION REPORT Page of 2 <br /> Division of Safety and Buildings <br /> in accordance with,Comm 85,Wis. Adm. Code <br /> Cotutty l3µr n r tf <br /> Attach complete site plan on paper not less than 81/2 x 11 inches in size.Plan must <br /> include,but not limited to:vertical and horizontal reference point(BM),direction and Parcel I.D. o 7 0A 401 y <br /> percent slope,scale or dimensions,north arrow,and location and distance to nearest road. o Lt 900 e <br /> Please print all infonnation. Reviewed by Date <br /> Personal information you provide my be used for secondary purposes(Privacy Law,s.15.04(1)(m)). <br /> Property Owner /n1 Property Location <br /> DC.6 A /A.,eC• Govt.Lot 1/4 1/4 S 7 T z/0 N R/q E(ord—v <br /> Property Owner's Mailing Address Lot# Block# Subd.Name or CSM# <br /> 3j"949 41; en Green Com+ 39 As a) T/aJ T VIYa w VIlli <br /> City State Zip Code Phone Number ❑city []Village ®Town Nearest Road 3.14-0 <br /> fve66fei wS I S'/"3 (6141 )?6p- //3E' .1;-079 I As .„ 6:e4d? l Cr+ <br /> ❑ New Construction Use:® Residential/Number of bedrooms 3 Code derived design flow rate NSO GPD <br /> 'Replacement ❑ Public or commercial-Describe: <br /> Parent material _ /r/Ac r.. / /Jr,eOy Flood Plain elevation if applicable <br /> General comments <br /> and recommendations: Sys . e/e✓. ti p pw r 9A , qj 983 fo 94�Lty� <br /> Jawee 91. 00 (cp.Go16. �?bo) <br /> MAY44 0 34486 : 4fribkwn )oaw a„ <br /> FTIBoring# ❑ Boring <br /> © pit Ground surface elev. �/S C ft. Depth to limiting factor 9 7- in. <br /> Sal Application Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF <br /> in. Munsell Qu.Sz. Cont.Color Gr.Sz Sh. 'Eff#1 'EH#2 <br /> / O• y 7.SYR 3/A •-- /S /er Ale M e S 3 /' . 7 1. 6 <br /> .Z H-36 7ryre 4/y /-1 t.,-orb/o . 1 67s Seo -7 <br /> /• G <br /> 3 Y4.-sol 7..fvR "'/v — S os< r ezs <br /> 4/ Sol -7y 7 S YR s/a — S D S 4 ,..., / — - . 7 1. 4 <br /> Boring# ❑ Boring <br /> ® <br /> © Pit Ground surface elev. 9J• (7 ft. Depth to limiting factor > 7) in. Soil ADDlication Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/f2 <br /> in. Munsell Qu.Sz. Cont.Color Gr.Sz Sh. 'Eff#1 'Eff#2 <br /> O - t4 7. SYR 31A — /s /... .16/e I l <br /> e s 3.-. . 7 /• 6 <br /> d v-,1 S' -7•sIr2 `�/y s 6 l .•.. I e3 3c0 .7 /' 6 <br /> .-- s'N 7.SyR -//4r -- S OJ e- 4,...1 G S d/'1 . 7 116 <br /> v str-7A 7.S iR 971 — s os� >M l — .-7 <br /> 'Effluent#1 =BOD >30<220 mg/L and TSS>30<150 nglL fluent#2=BOD <30 mg/L and TSS<30 mg/. <br /> CST Name(Please print) Signature CST Number <br /> JrAme.s 51:12,716 /1 4 7-fwa0 <br /> Address Date Evaluation Conducted Telephone Number <br /> of 7760 h4 3 s ttlP,6,51<rr u't 54843 <br />