HomeMy WebLinkAbout026-1294-18-000 (2)
EVALUATION REPORT Page of
Wisconsin Department of Commerce
Division of Safety and Buildings
d with Comm 85, Wis. Adm. Code tun
5•~ C ~
Attach complete site plan on paper not le@s than 8 1/2 x 1 Po U
include, but not limited to: vertical and horizontal referen a in 8 $i I . ! p O
percent slope, scale or dimensions, north arrow, and to ition and distance to nearest road. Date a
Please print all information. AUG 0 2005 d I
rmation you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)).
Personal info
Properly Owner ZONING OF IC ocati n 1/45 1/4 S a4 T30 N R E (or
Gera 1 ~ S M '
Property Owner's Mailing Addre ~ Lot # Block # Subd. 0." 1 O Name or CSM#
.c w►
F <
/ 90 NW
City State Zip Code Phone Number ❑ City ❑ Village ® Town Nearest Road
( ~ 8 ~ ~ c.ti rn Ave. .
R ~ ~ R SIN 3 o .
HK
Use: LA Residential / Number of bedrooms Cod derived design flo at G -
M New Construction D
❑ Replacement ❑~P~ublic)or commercial - Describe: -
Parent material -Q_ i *A _ Flood Plain elevation If plicab e
General comments S V c c e 5~ y -T r G, Lk" S e, q~ 6 C s r fiC" S a
.~J -r S el dl • 43 'f. 7 CIO o. b9 ~ c
and recommendations: 1
T. t C►o'1.•~ -r.3 C1p3•o1 s~TLo?i
603.56'~ 4 s'►~~•`/7') rt'~O~ lar.3►'~ T•8 CI'D1,0,
Fil Boring # Boring
Soil lication Rate
Pit Ground surface elev.1 a~•$ . ft. Depth to limiting factor , - in.
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots •E GPD/fFEff#2
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh.
►I) Yl2S/ L Fsbl c4, IF G
I•le.csvy Y` 4 ~F ~ E • ~
d "T 5 Yr' 4/10 _ rv "
r" E . E a to
5 s ` L
- Y A~-
l..~o T l
Boring
® Boring #
Soil Application Rate
Pit Ground surface elev. Depth to limiting factor t 5 in.
Horizon Depth Dominant Color Redox Description FTxture Structure Consistence Boundary Roots .E GPD/ffEff#2
In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh.
- ?
Y
~a 1 ~r~
1b -7,5Y01
.......wa•••". ~ ~ i ~T i~: irk ~..~,`t° ~ ...s . i...E
31--115 > •1
• =
• Effluent #1 = BOD > 30 220 mg/L and TSS >30 150 mglL Effluent #2 BOD < 30 mg/L and TSS < 30 mg/L
CST Number
-7 q
T Name (Please P :::~~ignatur
Add 7~s -6, L Date Evaluation Conducted Telephone Number
8 V
S~aa6
Property Owner Gcra Id4 Sm s l 1 , Parcel ID # _ Page C~_ of _
Boring # Boring Q
F,-31 J6 Pit Ground surface elev. bb / ft. Depth to limiting factor L
- ~ - in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 •Eff#2
0.13 f 0 YA -1/X L t: s b K MAY f J F Io
13 -Iq D 51L 2 E S bK m r C t.,)
I to FS'
f VA
S <
l~ s
F-T Boring # ❑ Boring r
Pit Ground surface elev. ft. Depth to limiting factor 0O in.
Soil lication Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF
In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 'Eff#2
l b--ID l t)9p3/a L F'PL mr,- Q, w a F 6 y,
o -aa Yt2s/ I F P L r r
l/ aL -3$ 7.5 %t~~~,b SlGav-y S~k yv ~ V F ! r
l -(00 5TP-V Y - L ~5 Mf~r 4~' y -7
o ?.s 25/ FS L d - nrn F':
r
F-1 Boring # ❑ Boring
❑ Pit Ground surface elev. ft. Depth to limiting factor in.
Soil R licafion Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff
In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 'Eff#2
Effluent #1 = BODE > 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.
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