HomeMy WebLinkAbout026-1294-21-000 (2)
Wisconsin Department of Commerce IL EVALUATION REPORT Page of
Division of Safety and Buildings
~accordahce Comm 85, Wis. Adm. Code unty Attach complete site plan on paper not less itrdn 8 1/2 x 11 i ches i5E ® t
include, but not limited to: vertical andrbrizontal reference int (BM), direction and arcel I.D.
percent slope, scale or dimensions, north arrow, and locatio and distance to nearest road. li'P
Please print all information. AUG 3 0 2005 eviewe Date
,
Personal information you provide may be used for secondary purpo s (Privac Law, s. 15.04 (1) (m)). f
Property Owner C + LL ZON cation
GerQ1 . Sty r-`•n Govt. Lot 1/4 SW1/4 S p~~ T3(~ N R E(or
Property Owner's Mailing Addre, Lot # Block # Subd. Name or CSM#
00_ I 90 e• NW =tI 4.t OF tc M Acres
I I 1
city State zip Code Phone Number ❑ City ❑ Village ® Town Nearest Roth
~!K R~~R MIN 30 ( ) 8►ic.hr~ 13`! ve.
New Construction Use: Residential /Number of bedrooms Code derived design flow rate GPD
❑ Replacement ❑ Public or mmercial - Describe: -
Parent material _ btrY W 4,S ILIN _T'' 11 M i _ Flood Plain elevation if applicable - fl.
General comments } C vg 5 e S 't 3- T r-~ r. e-~`~
and recommendations: (9S.510') y 4 y~ 1. a r -4 V ti KK Ow vV
6:"~L 54 T,195.as ~ (q y.3t) Ft s
T•3 (9ysy') -ra. ( 9y,ao,~ r • I
Boring # Boring I^
pit Ground surface elev. _ 99-• _ ft. Depth to limiting factor in. Boil 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
i , UYR 3/a - L so w, Yo >!r a Lo :2 1= Ito J
F4-al Boring # D Boring p p ~v
Pit Ground surface elev. Depth to limiting factor V in, Soil Application Rate
Horizon Depth Dominant Color Redox Dedcription Texture Structure Consistence Boundary Roots GPD/fF
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2
F t le .
1 04 ~0Yik 3/;, L ~~sbK mfr a. (,j
n g` QQeketS 4 5W1 944 SL (I575lp
Effluent #1 = BOD > 30 220 mg/L and TSS >30:_< 150 mg/L ' Effluent #2 = BOO 30 mg/L and TSS < 30 mg/L
T Name (Please P Signature CST Nu, ber
t f(~
Add ss a 0 -t ti S-~ Date Evaluation Conducted Telephone Number
35s8
,*6 a w -7 -d. GIs a V8
Property Owner Gcra & Sm 141, Parcel ID # Page CQ_ of
Boring # ❑ Boring p
PS. Pit Ground surface elev. 7.33 ft. Depth to limiting factor y - 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
' Ivy C tJ ~°A • fo
on - anVo A
F-1 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/ff
In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 'Eff#2
a 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/ff
In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2
Effluent #1 = BODS > 30 5 220 mg/L and TSS >30:5 150 mg/L ' Effluent #2 = BOD5 < 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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