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HomeMy WebLinkAbout030-2131-41-000 (2) ..3 'W/isconsin Department of Commerce SOIL EVALUATION REPORT Page of Division of Safety and Buildings u in accordance with Comm 85, Wis. Adm Code County 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. 2 percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Revie 3 3 / Date Please print al )~rowsaa ! 3 03 15.04 (1) (m)). Personal information you provide may be used for secondary purposes s. (n s. arty Location Property Owner 00 2 vt. Lot VW 1/4 1 /4 S Z T 3U N R 00 E(or)6 l 1' C0.r ~ l0.. ~Vd L t # Block # Subd. Name or CSM# property Owner's Mailing Add Z U ~t W Village ®T City Nearest Road Phone LNLb umer ❑City ❑ Zip Code S r ~ U-, O. N g2 o51 ),A YA -ZLA-\` s Code derived design flow rate D GPD New Construction Use: Residential / Number of bedrooms ❑ Replacement II ❑ Public or commercial - Describe: ft Parent material t i r I Flood Plain elevation if applicable General comments 5y 5t e m and recommendations: (IoA+00c z1eU• Boring # ~ Boring 3 ❑ 9 Q g Depth to limiting factor in. Soil Application Rate Ground surface elev. ~ ~0 Texture Structure Consistence Boundary Roots GPD/tt2 Horizon Depth Dominant Color Redox Description Gr. Sz Sh. 'Eff#1 •Eff#2 in. Munsell Qu. Sz. Cont. Color - rJ i 1 ©r \ D l' 2rrhk mr^ C l v 2 I Sr'! - _ ~ - 3 ~SZj ~~(o CZP ~ .5 r4~t-0 mob ~~r . LI Boring # ❑ Boring S Pit Ground surface elev. g. Depth to limiting factor in. Soil Application Rate Texture Structure Consistence Boundary Roots GPD/ft= Horizon Depth Dominant Color Redox Description •Eff#1 •Eff#2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Sid 2 S m~r Z 14- '-k _ 3 3 Lfs l0 4 sc) ZmSbk mfr • Effluent #1 = BODS > 30 < 220 mg/L and TSS >30 150 mg/L ' Effluent #2 = BOD5 < 30 mg/L and TSS < 30 mg/L Signature CST Number CST Name (Please Print) ~ 33Q~j Date Evaluation Conducted elephone Number Address~Th ? 015X q 2113 Property Owner ' I (IC~C~ t Y~k^~5 Parcel ID # . Page 2 _ of -J. Boring # ❑ Bodng Pit Ground surface elev. 3 0 L= , ~-7-0 ft- Depth to limiting factor O In. V Horizon Depth Dominant Color Redox Description Texture Soil Application Ra In. Mansell SzStruck" Consistence Boundary Roots z Du. . Cont Color GO. Sz. Sh. GPD/fl 'Eft#1 .Eff/12 15 8 2 (~2 IU y C5 ~~3~ (D Zrr 'b~ m r C a Boring # ❑ Boring • ❑ pit Ground surface elev. ft. Depth to limiting factor in. Horizon Depth Dominant Color Redox Description.., Texture Structure Soil Application Rai In. Mansell - Consistence Boundary Roots GPD/fl= Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 Boring # ❑ Boring ❑ PiC' Ground surface elev. IL Depth to limiting factor In. Horizon Depth Dominant Color Redox Description Texture Soil Application Rat( In. Mansell Structure Consistence Boundary Roots GPD/ftt Ctu. Sz. ConL Color Gr. Sz. Sh. 'Eff#1 'Eff#2 - ' Effluent #1 = BODS > 30 < 220 mg/L and TSS >30 < 150 mglL • Effluent #2 = BADS < 30 mg/l4 and TSS < 30 mg/l. The Department of Commerce is an a tat Opportunity service provider and employer. Tf 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. SBDI))0 (R07/00) i PAGE_.~> OF 3 NAME Oa C r I OT# LEGAL DESCRIPTION~QUJ X Sw'a ,S Z ~ T 3o N.R. 20 E(or)&'g SCALE; 1"= G/U BM 1 ELEVATIONjpy - BM I DESCRIPTION BM 2 ELEVATION BM 2 DESCRIPTION SYSTEM ELEVATION /oo S o SYSTEM TYPE M o j &(4 _ CONTOUR ELEVATION qT, -7-6 f rov vi 0 1, ~ a L1 SIGNATURE DATE III