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HomeMy WebLinkAbout032-1004-30-000—Cqo,7 PIA. I ( 7�25 O 3 !±2 Wis. Dept of Safety and Profes9ttn81riefib SOIL Page of Division of Safety and Buildings ce �ith SPS 385, Wis. Aden. Code + m aarordan Attach complete site plan uiipCountyaper fef lex tharr�T12 S� 11 inches in size. Plan must include, but not limited to: vertical and horizontal reference point (BM), direction and paw I.D. tit`ar 0-� percent slope, scale or dimensions, north arrow, and location and distance to nearest road. ( z - 1 60 yp-6o 0 Please print all information. Reviewed by Date Personal Lnformation you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Prope Owner // Property Location f J Q woqe" KeA/ `© tvS'/'[ r Govt Lot SW 114 A/k/1/4 S T r N R! f 000 Property Owner's Mailing Address Lo # Biocc # Subd. Name or CSM# , aS' folk Sala �- c�o,,r R� Ci State Zip Code Phone Number ❑ Cit ❑ Village ®Town Nearest Road r►�erS'-!t 4AJ S ?S c o Me lj--e t' C .�. Z New Construction Use: 19 Residential / Number of bedrooms 51 Code derived design flow rate d GPD Replacement /� El Public or camal - Describe - Parent Parent material t�GL /_ Cf,, 4 SA / /G 1117-r Flood Plain elevation if applicable 4q ZP,4 i E X, ft. General comments and recommen ations: / �� Ej Boring [j] R Boring # /J pit Ground surface elev. / /r el ft. Depth to limiting factor /// in. Soil Application Rate Horizon Depth in. Dominant Color Munsell Redox Description Qu. Sz. Cont Color Texture Structure Gr, Sz. Sh. >nsistenoe Boundary Roots GPD1ft ' ff#1 ff#2 -Iy /oYR?iz M14 M411 4qs 11P 41y 01 2 IY-36 M y % k SL /nSdk I �'; c w 30117.51 0,7 F2_1 Boring # 0 Bonng/y /r C9 pit Ground surface eiev. 0A J ft. Depth to limiting factor ! in. Soil Application Rate Horizon Depth in. Dominant Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr, Sz. Sh. onsistence Boundary Roots GPDM = ff#1 ff#2 1 0-7 LO I 3� In " r��f `f r C/ a, � 2 7- 6 L SG s /7710,' C to, 1 1- ©r 6 /, Zvi ©s127--- -- Qr 7 1, ' Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg1L ` Effluent #2 = BOO < 30 mg/L and TSS < 30 mg/L CST Name Please�1 nt� ra S nature CST er Numb( 1,7c f/ ! / Address Date Evaluation Conducted Telephone Number ��i Property Owner { ! l �e) LU S�'C Ir Fj I Bonn it ❑ Boring Parcel ID # d 3 Z— /60 V ~—b-aoQ Page Z of 9 ® pit Ground surface elev. ft. Boring # ❑ Boring ❑ pit Ground surface elev. f. Flarizan Depth Dominant Color Red©x Description Texture in. Munsell Qu. Sz Cont. Color Depth to limiting factor /oC o in Depth to limiting factor tn. Sat! lication Rate Structure insistence oundary Roots GPDIft ' Gr. Sz. Sh- F-1 goring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor ' Effluent #1 = BOD s > 30 < 220 mg/L and TSS >30 < ISO mg/L ' Effluent #2 = BOD ` 5 _ 30 mg/L and TSS < 30 mglL The Dept. of Safety and Professional Services is an equal opportunity service provider and employer. If you nP.A - access services or need material in an alternate format, contact the department at rnQ " - 5BD-6330 (R 1 ll! 1) r Wis. Dept Safety Profes"LSOIL E ©R�w Page 3 of and .4"20 of Division of Safety and Buildings c rY, +dame SPS 385, Wis_ Adm. Code r County M I', �UeV�4ment Attach complete site planntipaper 11 inches in size_ Plan must r •' include, but not limited to: vertical and horizontal reference point (BM), direction and percent slope, scale or dinmsions, north arrow, and location and distance to nearest road. Parcel I.D. ~{'} d z - 1 b0 Y-,?0- 6C G Please print all information. Reviewed by Date Personal information you provide may be used for secondary purposes (Privacy Caw, s. 15.44 (1) (m)). }t �7�, -Z Prope ner r LOwe" K t) cv ��� Property Location +' Govt Lot S W 114 h'kll14 S A T / N R / ! (or)o Property Owners Mailing Address 6 S- P611C 56 J4 r Cro,`� W Lol # Block # rubd. Name or CSM# e- rrn Ci State Zip Codes �rPhone Number Village ®Town Nearest Road 0Yo - rltietc'it G�� S Ga ( ) Me lj-e r 1 6 74Y 9), jS New Construction User Residential 1 Number of bedrooms Code derived design flow rate 4 GPD Replacement 0 Public or comet al - Describe: /r Parent material QL( 1f" Gt� a S`i /"Je, • 17f Flood Plain elevation if applicable //rr ZPJ/�.I X ft. General comments and recommen ations: ?J"p"t U sa.� Baring # Baring t+sl Pit Ground surface elev. r r ft. Depth to limiting tartar // in. Soil Application Rate Horizon Depth in. Dominant Color Munsell Redox Description Qu_ Sz. Cont Color Texture Structure Gr. Sz. Sh. onsistence Boundary Roots GPDIft } ff#1 ff#2 3 36-I11 75�''f S DS !7'IL Boring # Boring r / Pit Ground surface elev. � ✓ ft. Depth to limiting factor (r in. Soil Application Rate Horizon Depth in. Dominant Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr, Sz. Sh. onsistence Boundary Roots GPDIft 2 ff#1 ff#2 L. 7- d 11% Y L 1.20�� /'r ! c lvr- c 6 0 6-11Y 7, Sy q & / S DS L -- — O, -7 1, ' Effluent #1 = BOD 5 > 30 < 220 mg,L and TSS >30 < 150 mg/L ' Effluent #2 = BOD c 30 mg/L and TSS < 30 mg1L CST Name (Please,'{intj Signature 1,7 ,n12 4 fla V— T Number ;Uzzlz Address liq,2 Date Evaluation Conducted Telephone Number SBD-83?0 (RI ill I ) PropertyOwnerko ell' ^' ��f Parcel ID# �2— 160V—_-?6-Oa4 Boring # ❑Boring 3 S ®Pit Ground. surface eiev. O � ft. Depth to limiting factor in. Page Z of 3 Sail Annlim inn Rate Honzon Depth in. Dominant Color Redox Description Qu. Sz. Cont. Color Texture Structure Gr.. Sz. Sh. onsistence Boundary Roots GPD/ft 7 ff#1 ff#2 jMuns�eell L !m / /! �'Ijy, f`re � f f [/` br / y z 117tSyfl v1 M g/ c w j v A D, l, 4 3 /-1Z 76 / IVk MS 61,9 L -` 6,7 1 r 6 F-1 Borg # ❑ Boring ❑ pit Ground surface elev. ft. Depth to limiting factor in. Snil Annliralinn Rat. - Horizon Depth in. Dominant Color Munsetl Redox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. onsistence Boundary Roots GPDift ff#1 ' ff#2 Boring Boring # Ground surface elev. ft. Depth to limiting factor in. Fl1 l_ t Pit Snil Anntiralinn Rat. - Horizon Depth in. Dominant Color Munsell Redox Description Qu. Sz. Cont Color Texture Structure Gr. Sz. Sh. onsistence Roundary Roots GPD/ft 7 ff#1 ff#2 ' Effluent #1 = BOD , > 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD , < 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 608-266-3151 or TTY through Relay. SBD4330 (K] U] 1) �ovvl� Name Address b 25 - Fa Ik S,,. Cro; rc R.P. 50 M t t SCE- W Z, 5,Y©2 ,4- A Benchmark 1 4�— 4. /lip, d ° "7`?`'*-- r"fe- A Benchmark 2 Sail Boring ,_r Suitable Area 1 " = 40' Scale Page 3 of 3 Brian Parnell CST 2.31314 Date " - ,► . SEEM 0 OEM 0 ME �M MEN ��..�.1.•+'+■.�:� 0- C3 to a