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HomeMy WebLinkAbout032-2133-10-000 Wisconsin Department of Commerce 1101, ,AND SITE EVALUATION •rDivision of Safety and Buildings Page of Bureau of Integrated Services i clgl&dance frith s. ILHR 83.09, Wis. Adm. Code r, l i',:~ County Attach complete site plan on paper not less than 11(ii 11 inches' iri'size:'Olan must include, but not limited to: vertical and horizontal efer6ncetpgir~ (BM), direction and c/ a /X percent slope, scale or dimensions, north arrow, ndl4catioh and diitahcc t it arest road. Parcel I.D. # APPLICANT INFORMATION - Please I irk+'f PAM ~ fWR?Aw.E ~ Revieyyed by Date Personal information you provide may be used for secondary plWp6seS{Privacy Law, s. J Prope Owner ` ; i Property Location u 51t, p ~ ~ / C lelro, Govt. Lot Mcr 114S,4- 1/4,S T ?Q N,R / E (or)® Property Owner's Mailing Address Lot # Block# Subd. Name or CSM 1731 /Yk "'P'0c :j-f tc1 Ci Sttaattel Zip Code Phone Number ~t°W /I~G~7/hOw~t~c ~~G J 76/7 (~~''r ) Z76~✓~..~.1~ City /97e/ El Village ® Town Nearest Road Q New Construction Use: ® Residential / Number of bedrooms Addition to existing building ❑ Replacement ❑ Public or commercial - Describe: Code derived daily flow 6~" gpd Recommended design loading rate bed, gpd/ft2 trench, gpd/ft2 Absorption area required 500 bed, ft2 5.00 trench, ft2 Maximum design loading rate 2 bed, gpd/ft2 42 trench, gpd/ft2 Recommended infiltration surface elevation(s) /o 2. 5 ft (as referred to site plan benchmark) Additional design//site considerations Parent material G/4c 77 ky 4044^ Flood plain elevation, if applicable A ft S = Suitable for system Conventional Mound In Ground Pressure AT-Grade System in Fill Holding Tank U = Unsuitable for system ❑ S U S ❑ U ❑ S © U El s 2 U E:1 S Q U ❑ S ® U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench I 07, ~ R7 c 6,L, Zm . y . s- 2 8-z7 751Y i At S~ A m, j P, c w /M . V' _s Ground 3 27 9,0 S'YR C 2~ 3 ~~Il SL ,h1S6/G ~l~fi - /Y elev INK. Depth to limiting ctor in. Remarks: Boring # 0-6 JD Y~ SZ_ I/nfdk A01-~ C ~ 2m . L/ ~ 57- 2.S 2,sYR ~y czF >o R 6~~ SL / J6~ Ground r6 7~ Depth to limiting f ctor 2 in. Remarks: CS Name (Please,Ptrint) Signature Telephone No. 1)''iun i e 27 9J 71-5'- -Y7 3Z'9--? Address 7c? p_IfZ~V ~ Date CST Number /O 'e ~u ~ ~7ozr h= Z7'~la~ 2.3 /_T / RlkS4. 11 ~ 4;161S6n SOIL DESCRIPTION REPORT Z PROPERTY OWNER Page of PARCEL I.D.# D .72- 2006-16 Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots G~pjft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench 2 S /S 7~~yi/1n~ ~A/~~ 5/G /,r~'1S6`~ ~1~~✓ c ~u //rl . 5r e S 3Z /f /Sf/k ~Uf'✓ C Le. Ground /Y elev. y~ (Vf / ft. s~ CZji~ye Depth to limiting factor 3Z--in. Remarks: Boring # Ground elev. ft. Depth to limiting factor in. Remarks: Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench Boring # Ground elev. ft. Depth to limiting factor in. Remarks: Boring # Ground elev. ft. Depth to limiting factor in. 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