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HomeMy WebLinkAbout026-1294-49-000 (2) P VALUATION REPORT Page of Wisconsin Department of Commerce O Division of Safety and Buildings Peith Ina dan Comm 85, Wis. Adm. Code County C P'0 Sf,ill Attach complete site plan on paper not less than 8 1/2 x 11 include, but not limited to: vertical and horizontal reference int (RE GE D Parcel I.D. L 2 ,q L percent slope, scale or dimensions, north arrow, and locati n and distance to nearest road. Revi ed by Date Please print all lnformaficih. ra i_~ ( 2005 Personal information you provide may be used for secondary purp es (Privacy Law, s. 15.04 1) (m)). Property Owner S1. CR l!V00ion /~~t'a-~ ' St,,~•,-t h Z0N1 W.ECE 1145E 1/4 S p~$ T3(~ N R E(or Property Owner's Mailing Addre Lot # Block # Subd. Name or CSM# Ill IaO 90 e. N W !CitypCity State Zip Code Phone Number F1K R*40P, KIN 30 ( > - g C. ts~n [X New Construction Use: n Residential / Number of bedrooms Code derived design flow rate GPD ❑ Replacement ❑ Public or commercial - Describe: - Parent material _'V_ X.V CI- 1Flood Plain elevation if applicable ft General comments 5U550S" f -~rc'.v>C S f70Y'`-V G " and recommendations: V K V-1,0 010 W 33 yj~ I +e 4e, ,rS Q r, y dalo~_ -74z> s M Boring # Pit ring pp Ground surface elev. ft. Depth to limiting factor CS 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 l r 1 !iC " L 5~ rr~ .fir t t~ l0 1 r irL err . 1., av' i , q~ >>5Y 4v Boring # El Boring J?. ® pit Ground surface elev. II ft. Depth to limiting factor O S 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 1 cui C~ Effluent #1 = BOD > 30:5 220 mg/L and TSS >30:5 150 mg/L ' Effluent #2 = BOD 5 30 mg/L and TSS < 30 mg/L T Name (Please P Signature CST Number Add s a 't' Date Evaluation Conducted Telephone Number a'7% S-tcwf •-ag • os 7 is a yass8 ~'o r3► 6 Property Owner Gera Its ► Sm ►Th Parcel ID # Page C_ of _ F,-31 Boring # ❑ Boring Gj Pit Ground surface elev. ft. Depth to limiting factor g_ 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 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 Boring # ❑ Boring F-1 - ❑ Pit Ground surface elev. _ ft. Depth to limiting factor in. Soil Q 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 = BODS > 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.fi=) a hx o r ` p~ CJ O 99,96 _ irn 77 a s r oa C4 E' v n F - - 'd- ztaq~+ gel' , I l ~10 60P Got 0 :31YOS (b ° a o ~ c ~ r (OIL G't -o ' And° ° °vt cv s~~^-fTld~lp l ~0~~ i \ c°~a~ BLt:TSLSO ° = o snx~+ o 0 0 u ° o 3 m Rkcs,500 03 -f~ Np ° r ° 3 s I % ,,BLS \i j A 9010-9 ° 0~ ° I~ x~ b \ I I (bjt I` ` NS m O O w 7 C P y tt 1 C ~0 m~ 'xlo mNVmcs~yi o ° S'v dQ~l~ v ( 2 ti % ~4~f r....~... £ ~ c II iN) g° c ~ c° O / to I ~ x~' \ x t y !Ax z CIO, $4io5b ~Qm f f I yO i U O t, v x o~ O O ~o°' ° p > - - _ gsaO'm x iv 0•~• O x .a n 2 ~O zTz~efl2~ zam~ ~j- - RQ+~~ t ._•-'u~ \ ~ " y• O 2 > o~K~"m .°o mta"„~'i c I P Pg i n `i ~y -•i ~-1 a N va n rn rn mgF ty x.~..,~. x~ 210- 1116 y m 133&S HUOZt # Ir O' 1 - 2~Qqvuu >=c°am6 1 . •n-7 1 ; ` P mQ.>Spp$$ 3 1 e l Oy ~Z x P v} t ,V = -'a Q H~KF•HZFJm Y! ~ `I~ C'~ O~ ~ ~ O I ~o~gsyq I g GSp Imo j>fC°~yy°o I n~~, ~szo g No '~°''L' ~Zp°mo=n i gp J x ~`,f'L~ xP H ~~fyy2~n~sjmZOr J~' nQr~ Z Z~ »N m (V(,-~ 2 C; fr Q~K Z FN ZN ~~N O .o V `V .c / gcz~g~~g° <Wpm no O o Q \ 7 n a C ° > £ O N K K f 0 1 / x y ~ x x N t o ,L6f ~N) ti 6zZ x Q~ ~I I~ n a ~V I l t6 P x W i s- - u~ 1 a ,Z \ i f~ , a 1 345' f In T- A F o I L (i •'~;y LOI_ . t $'z;+ ~I11 ~ t r ~ -L~LSH191(1 - i1i86~I /,~6~ % 7\`!"1 x S tt° ova \ I eJ t~ \J tt.' I „98 ,6LI7~- S li~j It D r ( 10..... ( x 44 O C..iCWNN ! ' V t ~ ~ it o a g' x i P P i r \ CA) t N> t / f f ~ x~ II r1l o 3 ( f v?v tV +.2 e A to N o ..v° '~~I , o zZ - ~Y ~ 2 v \ -A v Cfl I L ` , ©m Q, i v t (Z 6 a w- 1 I w C~ 1 ti 24~ ° m Q a a l m ; I ~ ~ xpw O~ o ~ 'p ~ 1 ~ , ~ _,^4 ~ H ~ y f~,. ~ a IJ) 00 e ~°c m ('~tunuary Fjunoo wnuiuin/y ' ° ° ? I F~nG~, a~-or-sz x a I PFD 06T <~El ,061 ~a p c o ° y, uoi)~a ~aui°,~ Fr°ay7nos ~ LE. _