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F _ <br /> r Wisconsin Department of Commerce <br /> SOIL AND SITE EVALUATION <br /> •Wition of Safety and Buildings - Page of <br /> Bureau of Integrated Services in accordance with S. I1-HR 83.09, Wis. Adm. Code <br /> 'Attach complete site plan on paper not less Nan 8 U2 x 11 inches in size. Plan must County <br /> include,but nol.limited to: vertical and horizontal reference point(BM),direction and _ <br /> percenl stops,wale or dimensions,north arrow,and location and distance to nearest read. pacel <br /> 032.5208 02.-?l0 <br /> APPLICANT INFORMATION- Please print all information: Revlewe l by Data <br /> Pe,sorW Inlomlation you pm'Me may to <br /> used for semeMay purposes l Pmary Law,s.15.Ds(1)(m)). <br /> Property Owner - Property Location , <br /> CLARK e9I4KS0N GOA.Lot 2 va va,S qj T 4] .N.R 15 E(n w <br /> Properly Owoees Mailing Address' Lot# Block9 $nbd.Name or DSMp <br /> 60 E FL) . oc . 4 6g 69 <br /> City State Zip Code Phone Number ❑ City ❑ Yllage M Town Nearest Read <br /> OM PRAIRIE M� 55 6 c Gt _) oro 0759 [' 'w s' —7 S7AP�F5 GK. Rn -.ti <br /> New Construction Use: �Residenlial/Number of bedrooms _� Addition to existing building <br /> ❑ Replacement ❑Public or commercial_Describe: _ <br /> Code cloned daily flow 3m - go Recommenced tlesign loading rate 7 bed,gptl/ftz-6--trench,gpd9i <br /> Absorption area required 42q bad,R29 r ench,flz Maximum design leading rate -7 bed, tlz -.71fI2' <br /> n k 9 9pd/ trench,gptl/ <br /> Ri commi infiltration surface elevations) 3- [.f 9 - - it(as referred to site plan benchmark) <br /> Additional desigNsi/lla considerations - - - <br /> Parentmaterial IM1�Ar-I R�_nQlfr Flood plain elevation,it applicable NA tt;. <br /> S = Suitable for system Conventional Mound In-Grountl Pressure AT-Grade System in Fill Holding Tank <br /> U = Unsuitable for system s ❑ u S ❑ u S ❑ u ®s ❑ U Q S ❑ u ❑ S '0 U <br /> -SOIL DESCRIPTION REPORT <br /> Boring# Homan Depth Dominant ColorMONes Texture Structure Consistence Boundary Roots GPD/f1z <br /> in. Munsell Du.Sz.Cont.Color Gr.Sir.Sh. Bed Trench <br /> 7 ' 18 <br /> 7 .8 <br /> G cundund - �j f- —7R* 6 Hs - . 7 .5 <br /> el v. <br /> Deptii to s - <br /> yarflmiting, <br /> t fac or y <br /> Remarks: Ho A ryFn FhRru <br /> Boring# P <br /> 1 R 32 � 05 d( ,,... . S^ 2✓ . 7 �8 <br /> 6'IqZ /5 O5 C0 s 2co 4 '.E <br /> 3 R 6 his as rtr �' 2co • 7 -S <br /> Ground <br /> 7 <br /> Depth to <br /> limiting <br /> factor <br /> >-77--in. Remarks: Y <br /> CST Name (Please Print) Signature Telephone No. <br /> IcHARD oPK��IS � A /� 4157 <br /> Addr ss Data CST Number <br /> 2? <br /> 7&0 f-+w� -5-21r. JS 3670 <br />