HomeMy WebLinkAbout020-1363-10-000 (2)
Bureau of Integrated Services in accordance with s. ILHR 83.09, Wis. Adm. Code uav
Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. ""sr- Court
include, but not limited to: vertical and horizontal reference point (BM), di'ebl on arid A si G 1 percent slope, scale or dimensions, rorth arrow, and location and dista
`to'nearestAd. Parcel I.D. #
APPLICANT INFORMATION -Please print all inform iot1. Reviewed y Date
Personal information you provide may be used for secondary purposes (Privacy Uaw, s. 15.04 (1) (m)).
Property Owner Property Location
f i ? Q Q f' f.:~ Govt. Lot ' S Li 1/4 5i,,, 1/4,S .27 T ~q N,R fifer) W
Property Owner's Mailiyn~QSyAddress Lot # Block# Subd. Name or CSM# ~i (ail (y
3., @ kW. 4 , 1. ,~i % 5.. „~i'R ' ~.d t!`. t q R^a 'k,. a 6•,'.n', .fs { w i5
Ci State zip Code Phone Number Nearest Road
;J C Tt t 430 - r 5 0 El City ❑ Village T r I t , € i ~
New Construction Use: ❑ Residential / Number of bedrooms Addition to existing building
❑ Replacement X] Public or commercial - Describe: p
Code derived daily flow gpd Recommended design loading rate ! ~ _t'ied, gpd/ft2 R _t? -trench, gpd/fiz
Absorption area required -bed, 112 trench, It 2 Maximum design loading rate 67 bed, gpd/ft2-6-trench, gpd/!t2
Recommended infiltration surface elevation(s) 100, r It (as referred to site -_plan,, benchmark)
Additional design/site considerations 3~ Z )ti0 -tit./
Parent material _ It o 1 °4 ' r~, Food plain elevation, it applicable ft
S = Suitable for system Conventional Mound In-Ground Pressure AT-Grade System in Fill Holding Tank
U = Unsuitable for system W S ❑ U [ES El U ®S ❑ U [~T s❑ u ❑ S N U ❑ S MU
SOIL DESCRIPTION REPORT
Boring # Horizon Depth Dominant Color Mottles Structure GPD/ft2 Texture Consistence Boundary Roofs in. Munsell Qu. Sz. Cont. Color Gr. Sz_ Sh. Bed
, Trench
i 1 a-4S~l~t!? ~Sr me tJ' Fr
Ground 454 ?.S f fa 5 QS 1
elev.
Depth to
limiting
factor E L141 in.
Remarks:
Boring #
f 2 ~IZTV 3 fP Vr J `iI F f `k• bs CS
Ground ! elev.
Depth to limiting
factor
f! n. Remarks:
CST Name (Please Print) Signature Telephone No.
P_ 3
Address Date CST Number
• SOIL DESCRIPTION REPORT Page -L of PROPERTY OWNER
PARCEL I.D.#
Boring # Horizon Depth Dominant Color Mottles Structure 2 Texture Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh.
Bed . Trench
r j~ yam'7((,'t~
j 0-1o I{) _ 14_,{,ir,~ amsb^ r,1 C',S ~t ~ t I -A ~0 5~# • 5 V i` 5 15 ` b I' l VFr" C. S 1 , '
to 7: 1 Ground,
elev. r3 , 0
Depth to
limiting
factor , l fin.
Remarks:
Boring #
2A7 I k/; - 4 S airlti~^f f"#~~ ,S r
v,i 4 1 - 190,
Ground
elev.
tao~ft. ;
Depth to limiting r -71
factor
2150n. Remarks:
Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots P
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed . Trench
Boring# I o-1~+ )0 r~fjq -5 a rlsci£' iraiA C 5 2 .S
1`1 V 7,5 4
r U
s-t... -,.sy
Ground
Slav. I ot.~.5ft.
Depth to
limiting factor
f5&tn. Remarks:
Boring #
Ground
elev.
ft.
Depth to limffino
fadnra
in. Remarks:
SBD-8330 (R. 07/98)
l _ _
,
.
~I
I i
AL 57 PNWA
1432 12& STREET, NEW RICHMOND, WISCONSIN
715-246-2454
Tom Nelson
Certified Soil Tester 227387-Re&ered Sutra ian 8R007'13
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SCALE III _ 440
Tom Nelson -t OF BM 1. o~ -BM F
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