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Wisconsin Department of Commerce SOIL EVALUATION REPORT Page of _
Division of Safety and Buildings
in accordance with Comm 85, Wis. Adm. Code
County SA L co I
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 reference point (BM), direction and Parcel I.D. r`t >
percent slope, scale or dimensions, north arrow, and location and distance to nearest road. LCl ~'VV U
V, f
Please print all inthmiailon. R, ewe Date
Personal information you provide m (P cy Law, s. 15.04 (1) (m)).
Property Owner 6 - w Property Location
Rl C er Govt Lot SF 114 A/W 114 S J ( T -Z N R E (or)o
Property Owner's Mailing Address A~R Lot # Block # Subd. Name or CSM#
City State p C *_ffov ❑ City ❑ Village P> Town Nearest Road
U_~, ZONING O -FICE 13ZQ~ea 4-
341 New Construction Use: 9~ Residential 1 Number of bedrooms 3 ^ Code derived design flow rate _ -171-1 0L60 0 GPD
❑ Replacement ❑ Public or commercial - Describe:
Parent material Flood Plain elevation if applicable h
General comments Sy S e-k 2 a- (3 3 O
and recommendations:
_Boring # E] Boring
pit Ground surface elev. 9&, 30 ft. Depth to limiting factor in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF
in. Munsell Qu. Sz. Cont. Color Gr. Sz_ Sh. 'Eff#1 'Eff#2
O-U 0 312 - SI'1 Zm abk ry-~ CS k/L -'s -3
Z- S ~fy - Sid 2mSb M-~r C _ `f
3 ZS- I 5 d - 1.2
a Boring # t❑ Boring
L Pit Ground surface elev. q-:7,36 ft. Depth to limiting factor Z- in. Sod Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff
in. Munsell Qu. Sz. Con'. Color Gr. Sz. Sh. 'Eff#1 'Eff#2
- Z 2 Si 2tm C 5 (vf . S
2 12 2S 5; Ll 2t-r\ % mE C . 14
Z
3 2:S-I\2 10,446 - 5 C~ tml -7
' Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg/L ' Etftuent #2 = BOD5 < 30 mg/L, and TSS < 30 mg/L
CST Name (P Print) Sture u r
!<<
r<-
Address Date Evaluation ducted Telephone Number
IY: ( 27
Parcel ID # Page of _
Property, Owner 6
❑ G~
Boring # Boring
Pit Ground surface elev. U ft; Depth to limiting factor in.
Sod Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff
Gr. Sz. Sh. 'Eff#1 'Eff#2
in. Munsell Qu. Sz. Cont Color
2 5l C~ 2m t G5 - r `O
❑ Boring,
❑ Boring #
Pit Ground, surface elev. ft. Depth to limiting factor in. Soil A lica6on Rate
❑
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots .E GPD/ft~Eff#2
in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh.
i
Boring
❑ Boring # Ground surface elev----- ft. Depth to limiting factor in.
❑ Pit Soil fiication Rate
Horizon Depth Dominant Color RedoxDesuiption Texture Structure Consistence Boundary Roots E GPD/ft2Eff#2
in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh.
-
Effluent #1 BODS > 30 < 220 mgfL and TSS >30 < 150 mglL " Effluent #2 = BODs < 30 mglL and TSS < 30 mg/L
-rhe Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or
department at 608-266-3151 or TTY 608-264-8777.
need material in an alternate format, please contact the
S B D-x110 (R.0V00)
I -
PAGE-~-OF 3
NAME: e e ( LOT4 Z3 LEGAL DESCRIPTIONS I/4.#WI/4,S I T~N,R, E(or)o
SCALE: I"=O T F---
l ELEVATION: 0 y . U
r
D+ ey 0 `p P T
BM I DESCRIPTION: h
-5 L
BM 2 ELEVATION: _9 q 0 C
BM 2 DESCRIPTION:
SYSTEM ELEVATION: S I e J.
SYSTEM TYPE: q3 , 3
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SIGNATURE: - DATE: G