HomeMy WebLinkAbout030-1090-50-000 (4) os
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Wis.Dept.of Safety and Professional Services Sc • ■ ' • 1WRIPORT Page j of
Division of Safety and 8iiildiogs' moment
De'• ccordance with SPS 385,Wis. Adm. Code
.,•la,,,,,. County Dry
Attach comp plan on paper not less than 8 1/2 x 11 inches in size.Plan must
include,but not limited to:vertical and horizontal reference point(BM),direction and Parcel I . 111..-1 a
percent slope,scale or dimensions, north arrow,and location and distance to nearest road. ',0.- t 090•.S a - O e tic,
Please print all information. Reviewe!/td by / Date
Personal information you provide may be used for secondary pv'poses(Privacy Law,S.15.04(1)(m)). �/� /0 / 16/6 2 -z_
Property Owner C 1 Property Location (/ "`'��`��
Char41- 3eF ` Walaf;ofF Govt.Lot tit.)
1/4af 1/4 S31 T3D N R 1 C) E(or)W®
Property Owner's Mailing Address Coo-tack Lot# Block# Sr e ubd.Nam orCSM#
I80 fserrh l 0-kc R&., z o wv1, e.ewh a r e I at I,)k,-te E a n I e.
City State Zip Code Phone Number ,Z Tait/ ❑Village own Nearest Road
gudSDrJ 1 ttlt IS10it. 1 ( 6S1 ).ZR3-9829 5t, .7ose I Wk k fa51e IE DAS)
® New Construction Uses Residential/Number of bedrooms 3 Code derived design flow rate 9.50 GPD
ElReplacement 0 Public or commercial-Describe:
Parent material /O e SS Q J C.: 1 '1 Floo Plain elevatisn if applicable z��_ Y ft.
General comments s _ le"-:
C��/ �d.l or
and recommendations: "
/-
TC W I4 Sees-�.3 4400i or- `F `�i✓ teLe
) Boring# ® Boring
0 pit Ground surface elev.Slid)?
ft. Depth to limiting factor 3(? in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure onsistence Boundary Roots GPD/ft
in. Munsell Qu.Sz. Cont.Color _ Gr.Sz.Sh. *VW "Eff#2
I N.110 /DA3/a — S,L afsbk ash a ) aF . to . 9
. a 1D-15 to-r .5/w — S; L (rsb►(-- C9. h (-142 IoF c. 9 . le
- )S-aS 7.5104 51 (FS bit e,k c ►.J 1 F i y ,-7
y a5-37 SYa'1)b S L,- _1 F5 6 PE fjl h c (") — . 4 .-7
s 37.6D StiA F,F-7,SYai►Ie 5I- o-„,, d k. — t a a to
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a Boring# Boring Q d �
p,t Ground surface elev. /a•R ft. Depth to limiting factor 3 (p in. ,
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPO/ft 2
in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. -Eff#1 'Eff#2
I b-9 /DYR3h, 5;L ,aFSb1c 'Isl. (AO a . L. rg
- a 9-Ito ro Y,ks/s 5: L l F iG O 4, c w IF c. L/ . 14.
3 Ib-PY 75' A11j ---- .5i- I F564 Ilk Cu) IJF , , y .7
Y 91'/-3b SYay/ s L- ( Fstikc A h ct✓ — t y r 7
5 96-10o S"aVA' Fit 2s a'")v SL 0_1^v, Ail -- - a s L
'Effluent#1 =BOD ,>30<220 mg/and TSS>30 <150 mg/L -Effluent#2=BOD ,<30 mg/L and TSS <30 mg/L
CST Name(Please Print) Si nature
mber
Mann+A S, 54a.rK n - aal7'l(0
Address C s+ D&i8 Evaluation Conducted Telephone Number
a9/ a 0141
Ste r ?ftIr,e/ )I S` 0c?. cla 7-492- o ) 1a51-,a38-/61S
SBD-8330(R11'1 l)
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CI.Ql +3cfF
Property Owner w¢l&ro F F Parcel ID# Page of 3
3 Boring# Ie�1 Boring p p
4 pit Ground surface elev. JO�I2, ft. Depth to limiting factor_ 3 in.
Son Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDMt '
in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. •Aff#1 -tom
I o-10 1D`1R3/a - — Si aFsbK dsb Ow ac
to-It. IDIas/3 - — ,5- L IFS bit AID r t,,) / c. q . b
3 1641, 15IRi) i - , 5L. IFs bk 41, c IJF Li , -7
y _;1.-340 S A/ho - - 5L ► Fstl. Sk Lt.., — . , y ,)
s 34r- 60SYay/b 610.50.1'I? sL p.vn 3.1,, — . a , to El rig# Boring
pit Ground surface elev.92/1"'-0 ft. Depth to limiting factor 3 7 in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft '
in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. •EMI •Eff#2
I o-n 10-rR5/3. 5. L QEs!k it-, Q J aF • to , S
11-/4 Io'fMS1 _ S..L IFStiI. - C tA, IF .4 , L.
3 )1.-fib 7,5Y4',hi . si_ 1 F5_614 oil 6 Cw IJF , 1 . 7
y a6-37 sYR yla - S L- I i36t& h C — , 4 , 7
.S 37-(J7 sl2`I/b F147,51R 6)Fe S ►- o-w► a - - , a . L
1
Boring# Boring
Pit Ground surface elev. ft. Depth to limiting factor_ in.
1 Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft z
in. Munsell Qu.Sz. Cont.Color G .Sz.Sh. 'Eff#1 'Eff#2
•Effluent#1 =BOD ,>30<220 mg/L and TSS>30 <150 mg/L 'Effluent#2=BCD ,<30 mg'L and TSS <30 mg/L
The Dept. of Safety and Professional Services is an equal opportunity service provider and employer. If you need assistance to
access services or need material in an alternate format,contact the department at 608-266-31 5 1 or TTY through Relay.
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