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Wisconsin Department of Industry, SOIL AND SITE EVALUATION <br /> Labor and,Human Relations Page of <br /> Division oSafety and Buildings in accordance with s. ILHR 83.09, Wis. Adm. Code <br /> Attach complete site Ian on a County <br /> p p paper not less than 8 1/2 x 11 inches in size. Plan must <br /> include,but not limited to: vertical and horizontal reference point(BM),direction and e <br /> percent slope,scale or dimensions,north arrow,and location and distance to nearest road. Parcel I.D.# <br /> m/ 3 3 0 L f13o <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 /> ;m Govt.Lot ��1/4��J 1/4,S�s T�g ,N,R E(ore <br /> Property Owner's Mailing Address Lot# Block# Subd.Name or CSM# <br /> City State Zip Code Phone Number <br /> ❑ City El Village 2!1--7own Nearest Road <br /> New Construction Use: 014esidential/Number of bedrooms Addition to existing building <br /> ❑ Replacement // ❑Public or commercial-Describe: 1 — <br /> Code derived daily flow(9 V gpd Recommended design loading rate oed, d/ft2 .r <br /> gp trench,gpd/ft2 <br /> Absorption area required 990 bed,ft2 1000 trench,ft2 Maximum loading design �- <br /> g g rate�_oed,gpd/it2 P C trench,gpd/ft2 <br /> Recommended infiltration surface elevation(s) 75 ,V (as referred to site plan benchmark) <br /> Additional design/site�considerations C G. .0-'t 9 c/ <br /> Parent material V l/`t C/A /'%ye f Flood plain elevation,if applicable ft <br /> S = Suitable for system Conventional e�Mound In-Ground Pressure �AT-Grade System in Fill Holding� 'Tank1 <br /> U = Unsuitable for system 1:1U O ❑ U � EJI ^U � ❑ U 2f-& El El �"S / <br /> SOIL DESCRIPTION REPORT <br /> Boring# Horizon Depth Dominant Color Mottles Structure GPD/ft2 <br /> in. Munsell Qu.Sz.Cont.Color Texture Gr.Sz.Sh. Consistence Boundary Roots <br /> Bed , Trench <br /> Ground .2 ft <br /> 7,Sy�P �� C=,?.✓SJR 7 S C �� s /a/A �c✓! <br /> elev. <br /> Depth to <br /> limiting <br /> factor <br /> Ll n <br /> in. <br /> Remarks: <br /> Boring# 6 p <br /> e. �S .G <br /> Ground <br /> elev. <br /> Depth to <br /> limiting <br /> factor <br /> (6�in. Remarks: <br /> CST Name (Please Print) Signature Telephone No. <br /> / <br /> Address k Date CST Number <br /> 16 o X S/ ,-$''/-enJ (J — Z—oc� ._2 7GW <br />