HomeMy WebLinkAbout020-1306-90-000 (2)4p�1E,t�Dv.� dot'/' G/ ,U,¢ L TES T o/-- 7.
Wisconsln Department of Industry. SOIL AND SITE EVALUATION / 3
Labor and Human Relations Page of
Division of Safety and Buildings in accordance with s. ILHR 83.09, Wis.
Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must County p yy
include, but not limited to: vertical and horizontal reference point (BM), direction and
percent slope, scale or dimensions, north arrow, and location and distance to nearest road. I Parcel I.O. #
APPLICANT INFORMATION - Please print all information.
ed by Date
Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.P4 (1) (m)).
reW( i 2 • q • q7
Property Owner y yd
5�4(61Z - � £f'! //rT/U ��
Property Location
Govi Lot 5,e 1/4 Se 1/4,S 17 T 2- /6 ,N,R 17 E (oro
Property Owner's Mailing Address
6,03
Lot #
Block#
Subd. Name or CSM#
t//7,
City State Zip Code Phone Number
'1 ' 164E lL� Sy70 (7/S )�3/ DC�/p
Nearest Road
❑city Town 7ele/E _ZiJ
.
Ef New Construction Use: esidential / Number of bedrooms Addition to existing building
❑ Replacement 1 O/0 El Public or commercial - Describe: �1/p - NO (
U e7
Coda derived daily Bow gpd �C Recommended design loading rate bed, gpd/f12 trench, gpd/ft2
Absorption area required /V bed, ft2 7 trench, ft2 Maximum design loading rate bed, gpd/ft`7::rtrench, gpd/ft2
Recommended infiltration surface elevations) 1 C� 1 • 3 ft (as referred to site plan benchmark)
Additional design/siteoonsiderations *sC /f//fjL✓ 2�?�iUCLIs w/ fiw"-P do�
Parent material 1-04TS5 �VGiC itVr%y D Ld��/Gv Flood plain elevation, if appticable .,y/ ft
S = Suitable for system Convention al Mound / In -Ground Pressure AT•Grade System in Fill Holding Tank
U = Unsuitable for system S ❑ U ❑ S I'� U 5 ❑ U ❑ S ❑ S ❑ S
Boring #
Ground
elev.
too `1,C) _-ft.
Depth to
limiting
factor
7 7In.
Boring #
-7
,,.�.
F
Nmh
Ground
�felev.
Z.-C—ft.
Depth to
limiting
facar
SOIL DESCRIPTION REPORT
Horizon
Depth
in.
Dominant Color
Munsell
11 rtles
Ot C'.on(. Color
Texture
Structure
Gr. Sz. Sh.
Consistence
Boundary
Roots
GPD/ft2
Bed ,Trench
i
/.►A
�v/J�.Qe
Qs
3-F
,7 g
2
/Dy
�
/; ,
s
OS
GCF
C(
�
•% B
C
/0 yve
qy(�
. 7 8
Remarks:
ji mCr r]aI KS
;ST Name (Please Print) Signature -�� [� Z // / TeleP�ho� No�j h
�o� Eye 7- i!/6.P/GAT , CO]t13 pV�IU /i'isi/{i/j 7�s 3 d Ld S
4ddress Date CST Number
/� • S • �' �--- cST�i� Y�Z
Uibrlcht 8 AS11 iates
Private Sewage Consultants
655 O'Neil Rd.
Hudson, Wis. 54016
QRICINAL
RECEIVED �
DEC p g 1997 --
ST CROIX rip
COLINTv
20NINGOFFlCE
i�� �t
PROPERTY OWNER SOIL DESCRIPTION REPORT
PARCEL I.D.tf
Boring #
z
x-
Ground
elev.
!DD• —75--ft-
Depth to
limiting
factor
71: •k—in.
Boring #
Ground
elev.
—ft.
Depth to
limiting
factor
in.
Boring It
Ground
elev.
ft.
Depth to
limiting
factor
in.Remarks: -
Boring # �—
Ground
elev.
R.
Depth to f
limiting
factor
in. Remarks:
SBDW-8330 (R. OMS)
f
Page y of 3
Roots 2
Bed ,Trench
Horizon
Depth
In,
Dominant Color
Munsell
Mottles
Ou. Sz, Cont. Color
Texture
Structure
Gr. Sz. Sh.
Consistence
Boundary
�-
i 3
�o cT D
S/ L
/f si
4i 0 "
cS
010. Alp
R
LS
rP
ds
CS
7 S
Remarks:
c
Remarks:
Horizon
Depth
in.
Dominant Color
Munsell
Mottles
Qu. Sz. Cont. Color
Texture
Structure
Gr. Sz. Sh.
Consistence
Boundary
Roots
GPD/W
Bed Trench
r
i
312V VS
*,fd y
/, mo, j y°
Ob
LJ
}
� } 1
} ,
P7 / of L
SL•ooi — � � k � n��f �
' a
SGrO,/1�•l1a'/� �74� - � ,
hgL
i
R
0
ti