HomeMy WebLinkAbout020-1363-15-000
Bureau of Integrated Services in accordance with s. 13;109, :Wis, Adm. Code rage r of
Attach complete site plan County
paper not less than 8 112 x 11 inches in sit ~?lalrt must ~
include, but not limit4d to: vertical and horizontal reference point (BM) ,6lrecfdort and f ' " r7 L _ V,
percent slope, scale or dimensions, north arrow, and location and dist~e fo nearest road. Parcel IV #
210
APPLICANT INFORMATION - Please print all informa Jolh. ; ~Aeviewed.'
Date
Personal information you provide may be used for secondary purposes (Privacy Laver s ' 1.5.04 1 ry^
AIJA-
Property Owner ~ Rroperty
5(.3114,S Z T 2 `i N,R 1'9 -E-0) W
Property ! Owner's Mailing Address Lot _ Subd. Name or CSM#
t ` M !]vd ti 0 4 S Q.Q_ 4i ~v t~ 1C. # 1^~ LA. S { r~ @ r S 5~~&. 1C K
City State Zip Code Ptagpe Number ❑ City ❑ Village ( Town Nearest Road
t1-;J mn, 5 0 :1 ) U- 1s 0o 4Jk. t
04 New Construction Use: R Residential / Number of bedrooms Addition to existing building _
❑ Replacement Public or commercial - Describe:
Code derived daily flow h rt V gpd Recommended design loading rate bed, gpd/ft2 1.~ trench,
_ 9Pd/f?
Absorption area required bed, ft2 trench, ft 2 Maximum dosign loading rate / r bed, gpd/ft2 2 trench, gpdt t2
Recommended infiltration surface elevation(s) 100 ft (as referred to site plan benchmark)
Additional desigrUsite considerations
t
Parent material 0 e.51 S 0U f-11 Q t- A l..)c S tr . r Flood plain elevation, if applicable L+ _ft
S = Suitable for system Conventional Mound In-Ground Pressure AT-Grade System in Fill Holding Tank
U = Unsuitable for system ❑ S a U V S ❑ U ❑ s R u ❑ s M U ❑ S F) U ❑ S R U
SOIL DESCRIPTION REPORT
Boring # Horizon Depth Dominant Color Mottles Structure GPD/ft2
in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz_ Sh. Consistence Boundary Roots
Bed Trench
3 r
Ground 1 _6 l oyr
e-~,leffv~~.rr ra ty, .fit' r-
e,att. Ll _7
Depth to
limiting
factor
T- 1
Remarks:
Boring #
fog- to r 4 /4 - t t~ C' - . t~ ,
Ground 5714,
;t 5)L° t°1.5 J ,Jo
elev.
g4rf ft. ? III-IOU -1'5yr '/fO a S t 4 1 T
Depth to
limiting L Ll
factor
>I `9 O in. Remarks:
CST Name (Please Print) Signature Telephone No.
f i1~u 5u~/ d'F j
<.f
Address
i`~.~~. Date CST Number
22.?3$
PROPERTY OWNER SOIL DESCRIPTION REPORT Page Of
PARCEL I.D.#
Boring # Horizon Depth Dominant Color Mottles Structure 2
in. Munsell Qu. Sz_ Cont. Color Texture Gr. Sz- Sh. Consistence Boundary Roots Bed . Trench
Q-~ ION( 3 j Q.t S?atr' t~l fi W j
2 5~ 6c 'r 3 f I rnsb {~,r c CS
Ground
j` I~ tc~ f S, 1~Sb tRt P t.` - 41 S" -
5 1~ 5~'r $ S m S ewe r 17
Depth to
limiting
factor
y 111.0 n.
Remarks:
Boring #
` 2 43 E~ s S.1 a.rhSbi,/ rl~r c5 )t . ,
3-Sc i:a r =IJ - S-1 '(ISf,u' in f"
Ground L? q 1,j . T CJ A 7S r (vJB S-1 I t'1 S fi f r 3,
lev
Depth to
limiting
factor
Remarks:
Horizon Depth Dominant Color Mottles Structure P
in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Boundary Roots Bed Trench
Boring #
Ground
elev.
ft.
Depth to
limiting E-1 I
factor
in. Remarks:
Boring #
Ground
elev.
ft.
Depth to
limiting
factor
in. Remarks:
SBD41330 (R. [77/96)
i
1432 120'b STREET, NEW RICID40ND. WISCONSIN
715-246-2454
Tam Nelson
Certified Soil Tester 227387---Registered Sandanan SR00713
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