HomeMy WebLinkAbout004-1034-90-300 (2)r
in a
Attach complete site plan on not I"S Mhan 8 12 x Th'
include, but not limited to: ve grad horizdrttat refereru� point
percent slope, state or dimem nlotth ammm. W-4 and
Please sAf ffformadon.
P rsonat Wommillon You provide may be oiled for purposes
Property Owner
Property Owner's Mailing Address
So X P?"f- vEPf gD
65, Wis. Adm. Code
County
rze_ Plan must
duet Lion and I Parcel LD
istance to newest road.
Date
Law. s. 15.04 (1) anll.
Property Location
Govt_ Lot Ira W 1/4 S IS-- T-ap N R E (°o
Lot # Block # Subd. Name or CSIAS 00
p VWage RTawn Nearest Road
"l
New Construction Use: �Residentiat r N mbeer of bedrooms y Gads derived design flow' rate �f GPD
[
p Replacement p Public or commercial - Describe:
Parent materiaf C-rL �F Flo/o_dPtaw elevation V aPpicabfe ��/i3 fL
General cornt�i ���
and recommendations:
�f d�
Boring # p Bo�9
1 I P Pit Ground surface eAev. It. Depth to C~ni&V factor yl in. Soil Application Rate
. aw-m-M,
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9 Wn
it
F --—I .—. ❑ SonV
f • i 1
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MOM
Effluent #1 = BOO, > 30 a 220 mp/L and I ss Hsu !� »v mgrc
3T Nam (Please Pint)
idress Fogerty Pltfmbing +& Perk Testing Date Evaluation
Conducted
28288 McKenzie Rd.
ST Number
5--%jof
Page of
r,�c-ip r Parcel ID #
Property Owner J�L�--`�'
Boring # F Boring j. Ground surface el-v. ft Depth$0 limiting factor � in -
# Borx>cJ to *rMing factor
Ground surface etev. �—_— ft.' Sod icaticxl Rota
Pit y Roots GPDlff
r.4or.izonTDe�pp.th fkirnir�ant Redox DescrK�ian Texltxe �Structrre •Eff#1 'Eff#2
. MtnseA Qu. Sz. Cons- Color
Boring
0 Boring
Pit
Ground surface elev. ft.
Depth to biTiffitg favor in.
' Effluent #1 = BODS > 30 < 220 mglL and TSS >30 < 15Q mglL
Effluent #2 = BOD, � 30 mg1L and TSS < 30 mglL
ploYer. If you
ed
ccess
The Department of C'omrncrce is an equalfarmaortuopportunity S rttactchc departmetttte
at 64$7yf)C3141ar �1tassistance
64&264aB777 services or
need material in an altcrna , please
S6A-9330(R.6M)
Z
I9
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Fogerty Plumbing
#221180
28283 "".cK,�nzie Rd.
Spccnsr, 'NI 54801
(715), G35-9609
(s F 4=-4-6)
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