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HomeMy WebLinkAbout026-1097-80-100 (2)Wisconsin Department of Commerce RAJS EVALUATION REPORT Page 1 Division of Safety and Buildings '"Rre with Comm 85 Wis. Adm. Code County S-t CF " Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. percent slope, scale or dimensions. north arrow, and location and distance to nearest road. Please print all information. Revie by Rate Personal information you provide maybe us uses (Privacy law, s. 15.04 (t)(m)}. II Property Owner Property Location M i-C d t*e- G rr Govt. Lot W L91 114 VW 1 /4 S 4 T 3p N R Property Owner's Mailing Address NUV 1 2 007 Lot # 1 Block # Subd. Name a CSW / f f 7 Zf l3Uf� f}YG -- — J\fA — foAcvt 9-vc City State Zip o%49)jMftUNT-Y ❑ City ❑ Village MTom Nearest Road r 7� 4-4D M New Construction Use: ❑ Residential / Number of bedrooms zO Code de esign flaw rate ` WD ❑ Replacement Public :v or commercial - Describe:LZAL6NO da Parent material G 14. c-r - / T % �! Flood Plain elevation if applicable General comments Tv �� P %(Y -I +"v /pc•'stave. .. %pe p�5 %IS RI'' ��or V id%7 ,F�zo and recommendationst- r.f Jamb J �, U f ,. r � Lc � f' �r f! 1 �t „1 � 4 1�.+ tl� � ✓ • �L.. (JL.�-�'�.�. nL+ iJ � 1 ' ❑ ❑ Boring Boring # �O `+ g ® Pit Ground surface elev. o ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Descripbon Texture Structure Consistence Boundary Roots GPD/fF "Eff#1 -Eff#2 in. Munsell Qu. Sz, Cont. Color Gr Sz. Sh. T. 4/ — �r c 2 - q 1 k -n PA- s ! P• $ o- 5 E-l9 7.rI'll- 'Qr �- s 0s-It„ — 0,7 /- �- f�o�:�,� I,'N ed 4 6ah,h4 %r q P.,r x 41e vF r. / -;- //. lye n Not Boring # � Boring �i ^� ® Pit Ground surface elev. 7- 3 tt. Depth to limiting factor f !� in. Soil Application Rate Horizon Depth in. Dominant Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/fF 'Eff#1 "Ea t s -31 f!4- 04 ©. 4 0 5 f-106,7.s o �- d-7 /. Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 5 150 mg/L ' Effluent #2 = BOD,• < 30 mgfL and t S5 c 30 rrKYL CST Name (Please Print) �Si�a LureCST Number C{, a f 1 We- - 6 r ter C o� z Zb C 7 3. Address Date Evaluation Conducted Telephone Number Property Owner M i'C a h 14 c 1-t Parcel ID # p l o `17— 60— /00 Page z of 3 Boring # ❑ Boring ❑ Pit Ground surface elev. Y % --� ft. Depth to limiting factor :�' // o3L in. Soil Aoolication Rate Horizon Depth in_ Dominant Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPDIff 'Eff#1 I -Eft#2 -1 r-; s6 - s o S ,y, a - f 1-'-30 V - s t I z^'r K r r 'Z- I O. 4 c. 15 os4 0.71 6 Ha`- ati -> CC /V l A ° ❑ Boring ❑Boring # ❑ Pit Ground surface elev. ft. Depth to limiting factor in. ! Soii Ap lication Rate Honzon Depth in. Dominant Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD1fF "Eff#1 "Eff#2 %,t Z T l7 (y H P.. , r+ t' C / vrY- I c� a a- ; h llUw i k-1 4 ♦ Q r ctr er7' Y% dIt fC rt _Flic r q Ct t ? . Wer 1 c �c J ♦ f V r , ace /C if](o! /.� R �'e tea• ! h, h �L� �� tJ' •� %~ C ay^. ^ / ,�►�3f ry .S!>.� �C ihS QS �3'.�h � � �� or, G� Y7 �� Q`� h, h ❑ Boring II��Boring At Ground surfaceelev. ft. Depth to limiting factor in. ❑ PII Cnil Qnnlirafinn F?afa Horizon Depth in, Dominant Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz- Sh. Consistence Boundary Roots GPDIff 'Eff#1 I 'Eff#2 ` Effluent #1 = BODS > 30 < 220 mg1L and TSS >30 < 160 mg/L ' Effluent #2 = BOD5 < 30 mg/L and TSS < 30 m9fL The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or T'TY 608-264-8777. S8D-61310(R.07'UU) J r rrf l`OrlrCoyP�l+r eqCi�_� Yr G Pr-or4.+,4tes y ! 6f t, B -1 bp -a !3 -3 � f— l3a *4 Aye, " w e!1 /N�I framers ,.r epapa/r,.f 1000 scpt": t14 Poly /"k S72 \ FFlwr+. A /ter_ o t'aa�letE P��e/tRct�aCs Px 3 C -P 3 N Al -Sc a to /. ►r- z -f o At Ct kc-efat: aws not t d ) P449-«1 is loctcl•es to rate PA'" Here, p� -gr— wjr1 VRP= BOff*#"o, s'rd r•,p - E 1 = / too. o 9� 'U