HomeMy WebLinkAbout030-1066-10-010G3�C�C �Mf�D
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Wis. Dept. of Safety and Professional Se S3Crot>i--- Coral rLN' t_UATION REPORT Page of
Division of Safety and Buildings
in accordance with SPS 385, Wis. Adm. Code _
County
Attach complete site plan on paper not less than 8 112 x 11 inches in size. Plan must
include, but not limited to: vertical and horizontal referenda point (BM), direction and Parcel I .
percent slope, scale or dimensions, north arrow, and location and distance to nearest road. 1 <' - +Ad '
Please print all Information. lFle Iby v Date
Personal Information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). J L a
Property Owner Property Location
Govt. Lot /rt 'r 114 � , /4 T N R r E (or
Property Owner's Mailing Address Lot # Block # Subd. Name r fi
Lrc1 S.Ea/ I r city Stag Zip Code Phone Number ❑ City Village ,®Town Nearest Road
New Construction Use: Residential / Number of bedrooms Code derived design flow rate s ll' GPD
❑ Replacement ❑ Public or commercial - Describe:
Parent material tI" ,., 3 5�_ Flood Plain elevation if applicable T9/+ft.
General comments ✓ , , a -
and recomrr+enda6ons:
7 1Boring # ❑ Baring ) C _
Co Pit Ground surface elev. r_ ft Depth to limiting factor n.
S.-Al Ar,niiratian Rate
Horizon
Depth
in.
Dominant Color
Munsell
Redox Description
Qu. Sz. Cont. Color
Texture
Structure
Gr. Sz. Sh.
onsistence
oundary
Roots
GPD/ft
ff#1
ff#2
a
4
DBoring # u Boring
® Pit Ground surface elev. � 5'. ft. Depth to limiting factor in. Soil Aoolication Rate
Horizon
Depth
in.
Dominant Color
Munsell
Redox Description
Qu. Sz. Cont. Color
Texture
Structure
Gr. Sz. Sh.
onsistence
Boundary
Roots
GPD/ft :
ff#1
Ile-
{
" Effluent #1 = BOD > 30 < 220 rrKA and TSS >30 < 150 mg/L r ffiuent #2 = BOD < 30 mg1L and I bb < stf mg1L
CST Name P 91' nature - _ Sig /
,{1 //CST Number
Address Date Evaluation Conducted Telephone Number
Property Owner Parcel ID #
Boring 9 n8oring
� Pit Ground surface elev. ft. Depth to limiting factor in
C
Page I -X) of
I S.-A Annfiratinn P-;4—tA-1
Horizon
Depth
in.
Dominant Color
Munsell
Redox Description
Cu. Sz. Cont. Golor
Texture
Structure
Gr. Sz. Sh.
:;onsistence
Boundary
Roots
GPD/ft
-ff#1 *1
--ff#2
a
lU
2z
...................
❑
Boring# ❑ Boring
❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soii Application Rate
Redox Description
Qu. Sz. Cont. Color
F-1❑Boring # ❑ Boring Ground surface elev. ft. Depth to limiting factor in. pit I Soil Aodication Rate
Horizon
Depth
in.
Dominant Color
Munsell
Redox Description
Qu. Sz. Cont, Color
Texture
Structure
Gr. Sz. Sh,
" onsistence
Boundary
Roots ,
GPD/ft I
Fff#1 'tff#2
Effluent #1 = BOD 5 > 30 < 220 nVL and TSS >30 < 150 mg/L Effluent #2 = BOD :5 30 mgVL 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.
7-1 �nj,
CERTIFIED SURVEY MAP
LOCATED IN PART OF THE NW 114 OF THE SW 114 OF SECTION 25, T30N, R19W,
TOWN OF ST. JOSEPH, ST. CROIX COUNTY, WISCONSIN.
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CENTERLINE:
I
3.130 ACRES
3.14.2 ACRES
3.173 ACRES
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