HomeMy WebLinkAbout018-1086-08-000 (2)
Wisconsin Department of Industry, SOIL AND SITE NATION Page of
Labor and Human Relations
Division of Safety and Buildings in accordance wi s, 83:09, V'01 .
County
Attach complete site plan on paper not less than 8 1/2 x 11 inches in siz Wan musil
include, but not limited to: vertical and horizontal reference point (BM) iriilotlon and '
percent slope, scale or dimensions, north arrow, and location and distarice to ne4("t road. d?prcel I.D: 0 _
APPLICANT INFORMATION - Please print all informati n, Revieh#d Date
Personal information you provide may be used ry purposes (Privacy Law, 15,04 (1)4 N0" '
Property Owner teo LASo
-r c CIO ~WPe!?Y:toc~tior~ 9
.a d t+&3 13TH 0 10 Ill y Go~1# - 1/4 /VW 1/4,S Zd T ! N,R 6 (or) W
Prdperty Owner's Mailing Address Lot If Block# Subd. Name or CSM#
332- AiuatsoTA sr. EAST Iyo 8 4A"VVD eD/+&t
Z
city State Zip Code Phone Number Nearest Road IV Y.
ST• UL. HN. Y.510((oSI )222.5555 ❑ city ❑ Village Town 44 l&d
[ Iew Construction Use: IRHesidential / Number of bedrooms 3 Addition to existing building
❑ Replacement ❑ Public or commercial - Describe:
Code derived daily flow y~o gpd Recommended design loading rate bed, gpd/fl2 5r trench, gpd/ft2
Absorption area required 315 - bed, ft2 3~S trench, ft2 Maximum design loading rate bed, gpd/fl2 trench, gpd/ft2
Recommended infiltration surface elevation(s) SAL ft (as referred to site plan benchmark)
1 40
Additional design/site considerations
Parent material /O ErS "We QeN•sE- 7,1 Y/_ 3 Flood plain elevation, if applicable ft
S = Suitable for system Conventional ,Moo In-Ground Pressure AT-Grade System in Fill Holding Tank
L7 U 5 El U ❑ S ~ 1:1 S E/ ❑ S ER-t ❑ S
U = Unsuitable for system ❑ S T
SOIL DESCRIPTION REPORT
Boring # Horizon Depth Dominant Color Mottles Structure GPD/fl2
g Texture Consistence Boundary Roots
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed ,Trench
to./3 loggg J(3
51- he f/e _10e4 es
Ground
elev. G1 H015 SIGL /f~' - . Z • 3
O Depth to 1DY4
5Y Y/Co-
limiting 7• K
factor
Remarks:
Boring # Il • 2 S hJ It- S
a A 0, ! s •L 3 - /W '50- 1 /
Ground 20- ! Cz.A Hafs /?Gis 46 161 '•3
elev.
KI(Aft. t
o s Y~e
Depth to
limiting
fa for
xin. Remarks:
CST Name (Please Print) Rp13~RT NL~R~G~'T' Signature Telephone No.
s
~~s• 38G • gig
Address • Date CST Number
~ ~zCe375
Private Sewage Consultants
655 O'Neil Rd.
Hudson, Wis. 54016
A r
~1 UH $ I e0 I Aad SOIL DESCRIPTION REPORT
PROPERTY OWNER Page 2• of
PARCEL I.D.# 8AMMOAJ CIA k S g
Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GVpjft2
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench
i /o~i2 3 - L /~s~dif , /f . L( . S
/11 /tq V4 J/AK CS
Ground 3 S~ L:T✓ C S Z
elev.
A
UP eft. ~ o -f! f ,,w f.$ Depth to
limiting ;
factor
3-t- in.
Remarks:
Boring #
Ground
elev.
ft. ,
Depth to
limiting
factor
in.
Remarks:
i
Horizon Depth Dominant Color Mottles Structure GPD/ft2
Texture Consistence Boundary Roots
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench
.Boring # ;
Ground
elev.
Depth to
limiting
factor
in. Remarks:
Boring #
Ground
elev.
ft.
Depth to
limiting
factor
in. Remarks:
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Ulbricht& Associates
private SeWafle consultants
655 O'Neil Sid. 4018
Hudson, Wis. 5
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