Loading...
HomeMy WebLinkAbout020-1464-28-000 r Wisconsin Department of Commerce SOIL EVALUATION REPORT Page _ I of _ 3 Diviskli of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code County . C,(OI Attach complete site plan on paper not less than 8 112 z I 1 inches in size. Plan must include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. `L ~7`V ? ' C 1 Please print all information. Reviewed Date Personal information you provide mate us fP,; ;qY Law, s. 15.04 (1) (m)). 6 Property Owner Property Location cka Govt Lot S(, j 114 114 S T Z N R j!j E (ore Property Owner's Mailing Address « Lot # Biock # Subd. Name or CSM# © 12 2O City State Zi Cod6 ?UN ` I ❑ City ❑ Village ] Town Nearest Road Nlo Vt i,' New Construction Use: ( Residential / Number of bedrooms Code derived design flow rate SO-/ GPD ❑ Replacement I ❑ Public or commercial - Describe: Parentmaterial LAie T~ •S k Flood Plain elevation if applicable L! L-'Y_~--_-___ h• General comments sy yh I U G} ~`C) /Sjjy~ p~ (,a ~,p fi GZ O and recommendations: ~ ~n AA&4 - ~ 14 51.4,4 r/n~~' Boring# Boring Pit Ground surface elev. 9 U • 6 (3 ft. Depth to limiting factor in. Soil A lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDKf in. Munsetl Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 1 Q-{ 1( 3(Z S i( nor e 5 2- l A3 Id zi 4 S i c l v>n~r C_S 3 3--12,1 Q (414, O s Y-n 1 - J- Z Boring # Boring J! pit Ground surface el v. _ ft. Depth to limiting factor-11-7- in. Soil Application Rate Horizon Depth Dominant Color Redox Descrrp n Texture Structure Consistence Boundary Roots GPDIft2 in. Munseli Qu. Sz. Cone. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 3-Iy 'tz - 5i-( 2 m-~ 2 1q-2-4 5 i c I 2 sb n -P ti 3 Zit-I 7 S 05- - Z Effluent #1 = BOD > 30 < 220 mg/L and'F S >30 150 mg/L ' Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L T Name (Please P . t) S' nature CST Number Z` 3 /Ad Address Date Evaluation Conducted Telephone Num er ee-_--- Property Owner Parcel ID Page _ of F-S] Boring # ❑ Boring / Pit Ground surface elev. g~ SZ7 ft. Depth to limiting factor / ~l e in. V, Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots •E GPD/ft'Eff#2 in. Munsell Qu. Sz. Cent Color Gr. Sz. Sh. ! D-I $ 10 cjZ- i' ( 2 -b m r 5 Z 18 3F~ :S ci 2 c 5 - ❑ Boring # Boring ft. De th to lin"ng factor in. ❑ pit Ground surface eiev. P Soil A lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft' in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 ❑ Boring # Boring Ground surface elev. ft. Depth to limiting factor in. ❑ pit Soil A fication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 Effluent #1 = BODS > 30 < 220 mg1L and TSS >30 < 150 mglL ` Effluent #2 = BOD, < 30 mg/L and TSS < 30 mglL The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. snD-8310(R.07/00) ' PAGE a OF- NAME; de e LOT#_Sl_LEGAL DESCRIPTION:S11/44VEI/4,Sj -(TZJ-,N,R, IE(or SCALE: F e n1 t ELEVATION: IUV• 0 t I rr DESCRIPTION: ~Lg- al vC 1 BM BM 2 ELEVATION: `f / e p ~ - BM 2 DESCRIPTION: ~ew- SYSTEM ELEVATION: SYSTEM TYPE: 0OA u e y\ 4,-o na e(y`" J 2- 'Z -I SIGNATURE: DA E:R \