Laserfiche WebLink
Wisconsin Department of Industry, SOIL AND SITE EVALUATION <br /> ,Labor and Human Relations Page of <br /> Diyislon of Safety and Buildings 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 <br /> percent slope,scale or dimensions,north arrow,and location and distance to nearest road. Pdrcel I.D.# <br /> OZv 9350 02 _S60 <br /> APPLICANT INFORMATION - Please print all information. Reviewed b D <br /> Personal information you provide may be used for secondary purposes(Privacy Law,s.15.04(1)(m)). <br /> Property Owner Property Location <br /> Govt.Lot 1/4 1/4,S 7 T 140 ,N,R /rp E(or) rV <br /> Property Owne s Mailing Address Lot# Block# Subd.Name or CSM# <br /> o �r_ /Y i✓ <br /> City StateZip Code Phone Number <br /> 1jl . t1 tS -253 <br /> ❑ City El Village Town Nearest Road <br /> ,p <br /> ❑ New Construction Use: 4d Residential/Number of bedrooms 2- Addition to existing building <br /> XReplacement ❑Public or commercial-Describe: <br /> Code derived daily flow -%0 gpd Recommended design loading rate 7 bed,gpd/ft2 • trench,gpd/ft2 <br /> Absorption area required bed,ft2 trench,ft2 <br /> q5 .3 Maximum design loading rate _bed,gpd/ft2�_trench,gpd/ft2 <br /> Recommended infiltration surface elevation(s) ft(as referred to site plan benchmark) <br /> Additional design/site considerations <br /> Parent material rr Flood plain elevation,if applicable Niq ft <br /> S = Suitable for system Conventional Mound In-Ground Pressure AT-Grade System in Fill LHolding Tank <br /> U = Unsuitable for system S ❑ U S ❑ U S ❑ US ❑ U ,�] S ❑ U ❑ S U <br /> SOIL DESCRIPTION REPORT <br /> Boring # Horizon Depth Dominant Color MottlesFTextureStructure GPD/ft2 <br /> Consistence Boundary Rootsin. Munsell Qu.Sz.Cont.ColorGr.Sz.Sh. Bed , Trench <br /> . 703 • 7 •Y <br /> � <br /> Ground <br /> 'f D•U ft. <br /> Depth to <br /> limiting <br /> farAQr <br /> > in. <br /> Remarks: <br /> Boring# <br /> �� �s o N►1 j co 'i .2 <br /> 23V7 75y 'rte- ,>crs 1 >s <br /> Ground <br /> elev. <br /> IF <br /> Depth to <br /> limiting <br /> Mfa to <br /> in. Remarks: <br /> CST Name (Please Print) Signature Telephone No. <br /> PMOR42 14VPX1Pj—S1 <br /> Addr ss7-^7& ' Date CST Number 1 <br /> o A s4 3 S- 9-008�5' <br />