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Wisconsin,Department of Commerce SOIL AND SITE EVALUATION <br /> Division of,Safety and Buildings Page <br /> Bureau of Integrated Services 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. <br /> Parcel I.D.# <br /> APPLICANT INFORMATION- Please print all information. tTALiDo( 02-$- 410$- 01-(000 <br /> Reviewed by Date <br /> Personal information you provide maybe used for secondary purposes(Privacy Law,S.15.04(1)(m)). <br /> Property Owner <br /> Property Location <br /> 2-1 Nr� C--ZW AZDS [k Govt.Lot b 1/4 1/4,S 00 T o o ,N,R j q a(or)W <br /> Property Owners Mailing Address Block# ub . m <br /> SO CORAL E2 , Lot# or CSM# <br /> City State Zip Code Phone Number ❑ Ci <br /> g Alm N. t F(,3�Z (?(S ),Z City El Village Town Nearest Road L0^1 a <br /> 5q -343-7 7'AN A <br /> 0 New Construction Use: Residential/Number of bedrooms Addition to exisflng building <br /> .® Replacement ❑Public or commercial-Describe: <br /> Code derived daily flow d gpd Recommended design loading rate J1— bed,gpd/ft2 trench,gpd/ft2 <br /> Absorption area required �J'00 bed,ft2 7TC) trench,ft2 Maximum design loading rate •7 bed,gpd/ft2 ' trench, <br /> 9pd/ft2 <br /> Recommended infiltration surface elevation(s) 9'. Y ft(as referred to site plan benchmark) <br /> Additional design/site considerations If60tOg;g4f -, S srLGd-'J 117-- Us A41 415-f dp R1(��7€� <br /> Parent material C^LACI xt D�14-fi Flood plain elevation,if applicable n <br /> S = Suitable for system Conventional MoundIn-Ground Pressure AT-Grade System in Fill Holding Tank <br /> U Unsuitable for system s ❑ u Els ElU ❑ S El Els El EJs El ❑s ElU <br /> SOIL DESCRIPTION REPORT <br /> Boring# Horizon Depth Dominant Color Mottles Structure <br /> in. Munsell Qu.Sz.Cont.Color Texture Gr.Sz.Sh. Consistence Boundary Roots0 k-4e,�- 0-5 e:,— <br /> GPD/ft2 <br /> Bed , Trench <br /> Groundelev. 07 a 06u) <br /> m/ .7 <br /> Depth to <br /> limiting <br /> factor <br /> ->7-P—in. <br /> Remarks: CGA L /rte a5 7/ '' Al el SIO 7t- <br /> Boring# <br /> 01 ,s /2 % '' t5 D rt07-sc, 7 <br /> Ground <br /> pelev. 41 <br /> ! s• F-ft• <br /> Depth to <br /> limiting <br /> >!7fact At/QyZ <br /> —in. Remarks: 454 ST rzo Fo-A-/;7 OVEAZ -7-ed/77 71 7*A11C <br /> CST Name (Please Print) nature Telephone No. <br /> - <br /> 2z -7P' <br /> Address J Date CST Number <br /> C1. S ?- 97 W443 <br />