HomeMy WebLinkAbout020-1363-14-000
r ayv r U1 _~r
Bureau of Integrated Services in accordance with s. ILHR X09.! Ws. Adm. Code
Attach complete site plan on paper not less than 8 112 x 11 inches in size. Plan rrlbst' County
include, but not limited to: vertical and horizontal reference point (BM), direo/tand p~
percent slope, scale or dimensions, north arrow, and location and distance,"ta nearest r444Parcel ! D #
o- 3l0 3- -Olr6
APPLICANT INFORMATION - Please print all informatiotrl R w by Date
Personal information you provide maybe used for secondary purposes (Privacy Law, t$.4 (t} (m)) e L/oZ
Prope Owner s
PfYtpe~t}W00t OiFFIG1n J
U t S 1/4, 1/4,S 2 a T 2 N,R l ~ rtorrW
Property Owner's Mailing Address s Lo, Aleck#': . Name or CSM#
r` naa e.. -h t ► i) b ra ~Xa t -,,e Ira r
city State Zip Code Phone Number
i ❑ City ❑ %jllage Town Nearest Road
HAS" STS 42
New Construction Use: ❑ Residential / Number of bedrooms Addition to existing budding
❑ Replacement CVpubiic or commercial - Describe:
Code derived daily flow i4fNi'AOOA gpd Recommended design loading rate l__S_bed, gpd/ft2 ! (0 trench, gpd/ft2
Absorption area required bed, ft2 trench, ft2 Maximum design loading rate 1 5 bed, gpdJft2 trench, gpd/lt2
Recommended infiltration surface elevation(s) 01 ft (as referred to site plan benchmark)
Additional design/site considerations
s
Parent material i ae 't 4. C J'21 ; - s
ryn ' Flood plain elevation, if applicable E i c ft
S ' Suitable for system Conventional Mound In-Ground Pressure AT-Grade System in Fill Holding Tank
U Unsuitable for system S ❑ U IV S ❑ U [V'S ❑ U [YS ❑ U
❑S Eau ❑S 12U
SOIL DESCRIPTION REPORT
Baring # Horizon Depth Dominant Color Mottles Structure GPD/ft2
in. Munseli Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Boundary Roots
i Bed ,Trench
f Iif\ fI e d °1 ~r±~jI ~'f C S G
G 7,5yr 4N _IF s to
Ground.. 3 `.d ? _ r 5/4. f
3 r a 5 ,
elev.
1 ~ , v Z ft. '
Depth to
limiting
yfactor '
in. Rema W °t1 ca f Is. i I
Boring #
0-11 5-Al
I1°51 d0 C 5 - Sa~ '~r~~l C$ IF ptp
j 22- 16 r SK, F9, 7S s h as1 '1 0) 5 L~ - r
2 3
Ground ' f G
elev. s
5_gsfft.
Depth to
limiting
factor
Zf2'l in. Remarks:
CST Name (Please Print) Signature / Telephone No.
h r s S 5~l r ? 1. - i S 14
Address Date CST Number
PROPERTY OWNER SOIL DESCRIPTION REPORT
Page of
PARCEL LDI
Boring # Horizon Depth Dominant Color Mathes Structure
in - Munsell Texture Consistence Boundary Roots 2
Qu. Sz. Cont. Color Gr. Sz. Sh. ry i` C- i 0 1 t7 _ Bed ,Trench
14 f
Z
Ground "7 b d` r C.r 5
elev. t(~" -7fir _ S C5 ,S?
Depth to
limciitinng
7 {in.
Remarks:
Boring # 7 5 f' 3
c-)4) rn 56k rn4
2 I Ira V4, - fn
I'47 fo r Vb - S l ( MSS
Ground- f 7,5t r
elev.
fy\
Depth to
limiting
factor
Remarks:
Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots P /e
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench
Boring # 1 Q-i 4 3fz• S! r 6 ry\ r ,
Ground
elev.
Depth to
limiting
> k 0 in. Remarks:
Boring #
3-
Ground
elev.
Depth to
limitng
facia
in.
Remarks:
SBD-8930 (R. 07r96)
PONN
1432 120' STREET, NEW RICHMOND, WISCONSIN
715-246-2444
Tom Nelson
Certified Sail Tester 227387--Registered Sanitarian SR00713
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SCALE I"= 44 0
Tom Nelson
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