Loading...
HomeMy WebLinkAbout026-1149-00-012 (2) Wiscc ;in Department of Commerce SOIL EVALUATION REPORT Page I of Divisica of Safety and Buildings , 7 in accordance with Comm 85, Wis. Adm. Code ('rz iu County 1115 4 Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. 7 / percent slope, scale or dimensions, north arrow, and location and distance to nearest road. © Z l`` Please print all information. Reviewed by / /Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). l Property Owner Property Location Yt rl Govt. Lot S 1/4.5 1/4 S ~S T N R / S' E (or)Q Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# / `/3 C k 4, C,E (r ~ A-PA, C,1, 01 ,G /I S City State Zip Code Phone Number ❑~C Village aTown Nearest Road /V-cwr►~v~Q w~ Syo/z (7is- )Ze/e, - 3/Za t 6- on E~3 New Construction Use: f~ Residential/ Number of bedrooms 3 _ y Code derived design flow rate yrQ/ 0 d GPD ❑ Replacement ❑ Public or commercial - Describe: Parent material T r Flood Plain elevation if ap iliss6ls ft. General comments s'/S k WA eI --e- v U RECEIVED ~ and recommendations: ~1 yO MAR 1 3 2002 F-11 ❑ Boring ZONING OFFICE Boring # a Pit Ground surface elev. Y9 3d ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 0- A to 5L Z k t5 iv.C -S .9 cs - ~t 1UN-30 (0 Sc,L rnpr 30--Le t C3P L5 I MV-Pr c.-S - I. Z. 42- 1 p r ms DS m' - • 2 IT] Boring # ❑ Boring q ® Pit Ground surface elev. 99 3 6 ft. Depth to limiting factor o2 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 6-11) f .sc- 2m~ c..S ' S 2 16-Z / S L ~sb c.5 - * Effluent #1 = BOD5 > 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BOD5 < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) Signature CST Number 477-19- 3 o Address Date Evaluation Conducted Telephone Number z ESQ S P le/ s`~a z /2 is- o 7.s-,---/7 -y4~ SBD-8330 (R07/00) t Property Owner Parcel ID # Page Z of 5 Boring # ❑ Boring Pit Ground surface elev. 34 ft. Depth to limiting factor ►~5 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 O--tZ 16! s ems m l .5 -9 Z (Z-~9 fo 3 S c 2 k m-Pr c, 3 2~- 6 t L 5 m ;r C.3 - .-7 Z 1-57- ID r" C 41 L.s Zms Cs Z ( ifl mS f!s t 7 I. Z ❑ Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 Boring # ❑ Boring F1 ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 F- I I-T-T I i I -I * Effluent #1 = BOD5 > 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BODS < 30 mg/L and TSS < 30 mg/L 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. SBD-8330 (R.07/00) PAGE_ OF_ NAME T OT# 3 LEGAL DESCRIPTIONS C %5 X,S I S T 3d ,N,R, f fS $(orA SCALE: I"= ~I 1 BM 1 ELEVATION Xg0 G 1 " BM 1 DESCRIPTION -b ~ a ~ P v c P - ~e BM 2 ELEVATION__ L j. C O BM 2 DESCRIPTION ~a P (1 P u n~ _ _ SYSTEM ELEVATION ALTERNATE ELEVATION -711. CONTOUR ELEVATION (lam - I 6-3 Cl s„2 r.~ g z IGNATURE~ DATE f z - 3 G - o/ u.; r 6,paA ~ ~ t