HomeMy WebLinkAbout026-1294-30-000
Wisconsin Department of Commerce EVALUATION REPORT Page of ~ -
Division of Safety and Buildings ~s
in accordance with Comm 85, Wis. Adm. Code County
Attach complete site plan on paper not less than 8 1/2 x 1 inch s~•
include, but not limited to: vertical and horizontal referenc point l rFMlon an Parcel I.D. 3~
percent slope, scale or dimensions, north arrow, and Iota ion and distance to nearest road. Z(U ! Y
Please print all information. AUG q 0 2005 Revi ed b - Date ,r
Personal information you provide may be used for secondary pur~loses (Privacy Law, s. 15.04 (1) (m)).yt~~
Property Owner ZONIN Z%~L&afljo
1/45F 1/4 SajT30 N R E(or
Property Owner's Mailing Addre Lot # Block # Subd. Name or CSM#
I// to 90-Th e• NW o at o f fc rn vA. Acres
City State Zip Code Phone Number ❑ City ❑ Village ® Town Nearest Rooaact
F1K R-%l MIN 30 ( - 8 ~►ic-h M (o ,Sf,
IB New Construction Use: 16 Residential / Number of bedrooms Code derived design flow rate GPD
❑ Replacement ❑ Public 710 mmerciai - Describe:
Parent material Nh rj0ou rialn elevation I applica le - ft.
General comments ':r S to S 3& S -t 3 `0 roe e. c.-r- It., s ; to IF Iand recommendations: 'r `I ( 9 $ , s Y' I * VIV Kr%Ow ' ~t
1 T.I t'99.49 \
Jr'. I f- I . T-2 0 q,5~1'~ 5,'FG aa. 7,5 (10.491 11 S (0Gaj4C5L
T.3 (9Q.t9•~ -r.t- (It., q%) I'0. OCLz_
Boring # Pit D , b0 r
Ground surface elev. ~Q ft. Depth to limiting factor I ~ _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
v L4
9
®Boring # Boring
Pit Ground surface elev. ft. Depth to limiting factor 115 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
i 1)-,' ►1 Y► ' L JE ~1K mfr a ~ a
o I 4/ - L N_ Y c. w , (o
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Effluent #1 = BOD > 30 220 mg/L and TSS >30 5 150 mg/L • Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L
T Name (PleaAse P ' I Signature CST Number
Or t a.v-1G
a d,.V . ',t, " s Date Evaluation Conducted Telephone Number
' •a~-oS his dV8 :3588
t ` •
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Property Owner Gera idk T 51m .+k Parcel ID # Page i;;p_ of -_L
Boring # ❑ Boring -in.
F3_1 A Pit Ground surface elev. L o ~'S ft. Depth to limiting factor 9 S 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
l Q-~ '!JYP~ ~ aGG~R rY>~r ~w a F ~ In ~ g
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I 5 Y 44.
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i
V(,b S
F-1 Boring # ❑ Boring -
❑ Pit Ground surface elev. ft. Depth to limiting factor 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
Boring # ❑ Boring -
❑ Pit Ground surface elev. _ ft. Depth to limiting factor in.
Soil A 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
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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