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HomeMy WebLinkAbout032-2124-10-000 (2) Ipartment of Commerce SOS`-,-e..v SITE EVALUATION Page I of • 'ety and Buildings egrated Services in accordance with Comm 83.09, Wis. Adm. Code ..omplete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must County .ie,tyut not limited to: vertical and horizontal reference point(BM),direction and C Qo:`,c .,rcent slope,scale or dimensions,north arrow,and locatjaciand,distance to nearest road. Parcel I.D.# APPLICANT INFORMATION- P/ea illririt a/l rirnation, Re • ed by Date Personal information you provi.e may be used for p 0�es r y Law 8.1' ;04(1)(m))• f 2, zoo Property Owner v d Lie` Property Location �- x',t+ Govt.Lot 1/43,j 1/4,S 5 T30 ,N,R ) CC, E(orQ Property Owner's Mailing Address l Cr 30 X Lot# Block# Subd.Name or CSM# c� 13 5-3 lt,�,fa k. `g.; � / \ C1..a b a>_E 17d City State Zip Code Phone 1 um•e ', ❑ City ❑ Village ® Town Nearest \\ d tv I u.sL 15 i-f cu f ) r440 t S t wN✓czs -0-1-- I w y 35 L i E New Construction Use: a Residential/Number of bedrooms 3 — ii Addition to existing build g ra ❑ Replacement El Public or commercial-Describe: / j,1 S AV "{ a= ° 41 '' 5 ' -Q, f. •-c-1, Code derived daily flow 6 gpd Recommended designgdading rate ' • .4ed'gpd/ft2. gpd/ft2 Absorption area required FSS7 bed,ft2 7 5.--e> trench,ft2 Maximum design loading rate ,d'gpd/ft2 b lux**,gpd/ft2 Recommended infiltration surface elevation(s) q(CI O ft(as referred to site plan benchmark) Additional design/site considerations 4--4. e le-u . q 1. 3 0 Parent material 1"i ( ( Flood plain elevation,if applicable /C/ A ft Conventional Mound In-Ground Pressure AT-Grade System in Fill Holding Tank S = Suitable for system U = Unsuitable for system R S ❑ U 44,s ❑ U 11 S El U l 'S ❑ U El S ® U ❑s ® U SOIL DESCRIPTION REPORT Boring# Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft2 „.s„ in. Munsell Qu.Sz.Cont.Color Gr.Sz.Sh. Beer,Irefict 0._6• to Y¢ 3 i .3 —, S L ( MMAS 1`x (v FR- cc a/I ✓ s p. i , -2_ G-cot, tby�. ,� "� Ground elev. gw•70 ft. Depth to a�39Z,46 . limiting 3 2" , factor min. Remarks: Boring# ‘ o-s- to yo_ 7i 3 SL Irk r rtZ_ CS 1vF ,- .4 s )'.�_ '. - A�.•_r�• `) ,q 7 , 6- 1._ 5-10° *1(1 yr. 16 _ _ JL" J ' • • Ground elev. gi _ft. ' Depth to , limiting - factor /C°in. " Remarks: CST Name (Please Print) lL Sign ture y/' Telephone No. J4D A r'� SC Vntv�A` R •%%)_ � (17--/ y -7-- YeO 8` Address Date CST Number 2-0. <C). - S S cr\ 2s T [7 5-Yoz s—/s-er_. 25730C1 . '4 MIMir PROPERTY OWNER Sv �— SOIL DESCRIPTION REPORT Page of PARCEL I.D.# Boring# Horizon Depth Dominant Color Mottles Structure 2 in. Munsell Qu.Sz.Cont.Color Texture Consistence Boundary Roots 'G /ft Gr.Sz.Sh. h 3 I o-9 y tL 31 3 SL I ww4bri `v`t.ns. L5 t V 1= ,i,S ‘2- `I-cw i.o 0. 3 m t-S - ,L/✓�° Ground ,J elev. 4y zo ft. Depth to limiting 31.Z"��j2w factor qi`( `in. Remarks: Boring# y 0-6 (0 y2 3 /3 }61 `-1A-F2 F z s1 CS lv z. Li z 24' /o �R `1/� k F Cs ✓ ZH- v/Oyz.3 /6 — � C 7 y1+ S r Ground elev. c13 Po ft. Depth to limiting factor ALin. Remarks: Horizon Depth Dominant Color Mottles Texture Structure GPD/ft2 in. Munsell Qu.Sz.Cont.Color Gr.Sz.Sh. Consistence Boundary Roots Boring# 1 YtZ � �ed��.lsncrf' Boring 0,43,Ib 3 3 - SL ( K twf-rz, cf' (t) flitS,? 13461 'to y /6 Ground elev. cly./6 ft. Depth to 11'1/w, limiting factor /Ljn. Remarks: Boring# $ _ - l o-8-` le,try 73 �- z r / �- 1 1 gC�rM v S -. z 5r r w Zo_60Z 7Sy�y/� 5 . tort dtiot h1-cr f r li✓rk�D Ground �l 6.2 8?'Sy rY/g :y. v 4el i4ft. Depth to limiting 2 -0 -a/ factor Remarks: ,(75 /15 Fic/ C oo 4 /lC �S Qj„OU.e SBD-8330(R.9/98) consin Department of Commerce SOIL AND SITE EVALUATION is'ion of:Safety and Buildings Page of ,sureau•of Integrated Services in accordance with s. ILHR 83.09,Wis. Adm. Code Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must County /J include,but not limited to: vertical and horizontal reference point(BM),direction and .� (— (,r r-o ;yC percent'slope,scale or dimensions,north arrow,and location and distance to nearest road. Parcel I.D.# oh -5i4' L'y s�0.'tr 1Z.3o-S:Oopre, (!f/97zovo) Jov. a+ Pod APPLICANT INFORMATION- Please print all information. F f Iy t kdr Reviewed by Date Personal information you provide may be used for secondary purposes(Privacy Law,s.15.04(1)(m)). I Property Owner Property Location Govt.Lot S(,t) 1/4 5 to 1/4,S 5 T .rd ,N,R /�' E(or)W V � � S Property Owner's Mailing Address Lot# Block# Subd.Name or CSM# / C ( re City . State Zip Code Phone Number ❑ City ❑ Village II Town Nearest Road I I I ( ) Se.4nee-6e-f- 1 ❑ New Construction Use:- ❑Residential/Number of bedrooms Addition to existing building ❑ Replacement ❑Public or commercial-Describe: Code derived daily flow gpd Recommended design loading rate bed,gpd/ft2 trench,gpd/ft2 Absorption area required bed,ft2 trench,ft 2 Maximum design loading rate bed,gpd/ft2 trench,gpd/ft2 Recommended infiltration surface elevation(s) ft(as referred to site plan benchmark) Additional design/site considerations Parent material Flood plain elevation,if applicable 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 ❑S ❑ U ❑S ❑ U ❑S ❑ U SOIL DESCRIPTION REPORT Borin g# Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft2 IN .• .; .f in. Munsell Qu.Sz.Cont.Color Gr.Sz.Sh. Bed ,Trench I o-8 _ L ' -.fi. ' z '-20 DE sL r PA.tr , Ground 3 204 Z 5 L I C a . "`4/• . elev. ft. '1 42-n SYQ 4 y — S L -Pi Depth to limiting factor /Lin. Remarks: w z- . . . - .Ar_ .__, ."--.1 Ai, PI' `—J/� ■ : Boring# • . Ground ' elev. . ft. - , Depth to limiting ' factor in. Remarks: CST Name (Please Print)/ Signature Telephone No. ...Sow._ Son n eyy7aq q4,,,,,,,..- ----- Address Date CST Number (,.C7GG( " r PAGE 3 OF NAME _S-1 0c_.)v t LOT# / LEGAL DESCRIPTIONS'. 1/4S'J/4,S.S T 34,N,R(G E(or)v) SCALE: 1"= (26 BM 1 ELEVATION l00 •Q BM 1 DESCRIPTION,j 4(,'n (y A on EA, P0.5+ U I Flag BM 2 ELEVATION /00 • 0 5 BM 2 DESCRIPTION Na;(,•A 18'z(w+ C.(vs+e r w/Floc., SYSTEM ELEVATION 1 61C-2 f ALTERNATE ELEVATION 11. 3° CONTOUR ELEVATION i{// ,7 • , redei :5 ALA" • • • 'c •o ' • . N SIGNATURE DATE 5 l S -U v L