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Wisconsin Department of Commerce SOIL AND SITE EVALUATION
Division of Safety and Buildings Page of 3
Bureau of Integrated Services in accordance with s. IL14R 83.09, Wis. Adm. Code
14 Attach complete site plan on paper not less than 81/2 x 11 inches in §1ze. must F-Runty
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Include, but not limited to: vertical and horizontal reference point (BM), di on and
percent slope. scale or dimensions, north avow, and location and distan t"Oar
_ f108°d t Parcel I.D. #
o z a ~l~ 3
APPLICANT INFORMATION - Please print all Information Revi Date
Personal Intomratlon you provide may be used for secondary purposes (Privacy Law, s. 7 .Q41~ tm))r°+ri G (,PF. / 6(4
Property Owner by tcacatlon /
et) (1 S 1(m 0 r C' f ~ Govt. f t/4 SW 1/4,S 17 T I~ N,R 9 . G.(OPF) W
Property Owner's Mailing ress Lot # Block# Subd. Name or CSM#
I136~ nooAwes4mr, uerlae 3
14,_Ilwduz ffiyte Zip Code Phone Number ❑ City El Village T Nearest Road i -L
Town S T I-1 I
r' t f 1 S5 0 - ((ors ) J~~U 13
New Construction Use: ❑ Residential / Number of bedrooms Addition to existing building
❑ Replacement 0 Public or commercial - Describe:
Code derived dally flnrr AkCAtm gpd Recommended design loading rate __L_5 bed, gpd* r trench, gPd/1112
Absorption area required bed, ft2 trench, ft2 Maximum design loading rate • 5 bed, gpd* • G trench, gpd*
Recommended Nitration surface elevation(s) 04 5 . fy ft (as referred to site plan benchmark)
Additional desigrdsite considerations baen Sil l eyq 92-tcomme n 1".10 11. &a rvt G e rS
Parent material P S 5 ryl QR C) rti S , g rrlf! Flood plain elevation, If applicable 11 ft
S = Suitable for system Conventional Mound In-Ground Pressure AT-Grade System in Fill Molding Tank
u= Unsuitable for system [V S0 U WS ❑ u XS Ou (Z ❑ u ❑ S CCU ❑ S rWU
SOIL DESCRIPTION REPORT
Boling # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/1`12
Vill in. Munseif Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench
I o Id r VZ S 1 2ns~k r env z
Ground 3 1•yl 10 ` 0- ?-A 7.SYf Ir 56k tY1T't CS Alp •3
elev.
Depth to 0 7:
limiting
fact r
Remarks: g 7•5r 5
Boring # I 8-I5 o r z - S t d z~►S~k F r ec.J ZF
Z Z 15-z3 Ia r S1 4M50, f !r e-15 F i si ..~i
25-27 7 S l- G 5 rr, C 5 S
Ground g la e~ d 7. s r .861 i 1 M51 k' ~ i' - : 3
loo i s m I #14 c s , s;- G
3'45 s t - , 7
Depth to
limiting _j
factor
1.'2-.in. Remarks: 1 .S r !a 5 1 a t VA,
CST Name (Please Print) Signature Telephone No.
fihoN► q s C i e ~su~ 7! 5 2 Z yS'~
Address Date CST Number
PROPERTY OWNER SOIL DESCRIPTION REPORT
Page 2 of
PARCEL I.D.#
Boring # Horizon Depth Dominant Color Mottles Stricture a
Texture Consistence Boundary Roots
U1 I in. Munsell Qu. Sz. Cant Color Gr. Sz. Sh. Bad Trench
d-Z(► to V-,, - Si) Zms6tf- M r Z'a .2 .
Z Z G-33 e 414, ,
S S
ml
s
b's
Ground 3 33-~5 7-$rG t: - S 0 r1 e s ` . rv
[VLF. 4 ~s-ss /v r 6- 247 d sC/ MAI cS ,3
5
Depth to
limlang
factor
Remarks: S
Boring #
to, I d 30 o Z Zr4.;9 V Fr ew 2-, S; , G
Z o- 7.S rG & - S O ml t?S / ,7 . $
#G-51 to r G CL 7,5r4/8 Stl 0 p .3
Ground 74'V1, Vc, $ Ax VS l es
. 5 • ~o
el
Uev.O-A u- 7s r04 ~s / C. . 7 r
Depth to
limiting
fww
Remarks: , W~ itt n.s a F S 7 S Yr 01 1!!!M oT I- s 10}x/' ~lL
►-T
Horizon Depth Domkrent Color Mottles Texture Sure Consistence Boundary Roots
In. Munsea Qu. Sz. Cant Color Gr. Sz. Sh. g~ Trench
Boring # 10r a, S 156 ~r ew 2 f' , S : . ~
S
-S - S Os es i -'7
3 39-31 7. it, CS
Ground C 2 d 7, r c /.hsd ~j cs - fit/ •3
Depth to
limiting ;
In. Remarks: ~S
1aye4.af l , tlr~li AV 1 1r4ers j s 15yrS
Boring #
E3
Ground
elev.
ft.
Depth to
IGrsiting L± L
factor
-in. Remarks:
SBD4WO (R. 07198)
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1432 12& STREET, NEW RICHMOND, WISCONSIN
715-246-2454
Tom Nelson
Coed Sal Tester 227387---Registered Sagtum SR00713
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