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Wisconsin Department of Commerce SOIL AND SITE EVALUATION
*Division of Safety and Buildings Page ! of 3
Bureau 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
include,but not limited to: vertical and horizontal reference point(BM),direction and s�'-• (rb x
percent slope,scale or dimensions,north arrow,and location and distance to nearest road. Parcel I.D.#
APPLICANT INFORMATION- Please print all information.
77y Date
Personal information you pro -de may be used forir 5ecendary purpo (Privacy Law,s..15.04(1)(m)). 13 ZOU/
Property Ownel , 4 i -. :� ,Property Location
��
. s W' - Govt.Lot Sc,L3 1/4 1/4,S 5 T 30 ,N,R [ ct E(or) l
Property Owner's Mailing Address 3 ti.'". i Lot# Block# Subd.Name or CSM#
I53 Ike Y $..; bc . C hombre
City State Zip C e Phone Ntirber City ❑ Village Town Near t Ro d
7UCi3OY I 1)31 I 59 4(�1, )," �- o7� 5��e.,--r
I p-f
New Construction Use: ZeResidential/Number of bedrooms H Addition to existing building
Replacement ❑Public or commercial-Describe: / .-'t 3 eCe 8 y /40-7 $ h /via 4 e- • c
Code derived daily flow Co 60 gpd Recommended design loading rate 7 bed,gpd/ft2 O trench,gpd/ft2
Absorption area required 'S 7 bed,ft2 7 S3 trench,ft 2 Maximum design loading rate "7 bed,gpd/ft2 trench,gpd/ft2
Recommended infiltration surface elevation(s) 9 co CSC",X//y dryer) ft(as referred to site plan benchmark)
Additional design/site considerations /4- (-4. G 1-e v• cf a. 5'O
Parent material 4-7 l ( Flood plain elevation,if applicable /t119 ft
S = Suitable for system Conventional Mound In-Ground Pressure AT-Grade System in Fill Holding Tank
U = Unsuitable for system [ S ❑ U 4 S ❑ U [] s U lia s U ❑ s au ❑S U
SOIL DESCRIPTION REPORT
Boring # Horizon Depth Dominant Color Mottles Structure GPD/ft2
g Texture Consistence Boundary Roots �T -
in. Munsell Qu.Sz.Cont.Color Gr.Sz.Sh.
i o--�. U)yr.313 — 3(1 Imabk fCr c Iv •Zy- 3
Z ti yr(- 13 -" 5; l Y r G 5 -- - SV .1
Ground 3 ZJ--ico. 10 yr 3ho )....5 nn 1 '.. L S .--1, . .
elev.
gy20ft. rr
Depth to 4T 9z-
limiting Y,"
factor , ,
Zen. ,
Remarks:
Boring# I 6-4" My(-5113 i 1 . ,/ -
i�. mfr c S � v� Z , �
: Z 11-x• y — 5d 2rYr 4 c — • �/ - .i
:0 3 zo-53 • 0yr31(o ZS 1i) /71 fr-. cS - -2,/I ,
Ground ,
elev. ,
9Y-to ft.
Depth to ;
limiting -
factor .
99in. Remarks:
CST Name (Please Print) nature Telephone No.
ADAM h _ M • k. -CZ- -IS— ZY --uoaF
Address Date CST Number
2\\3 SO `Yt- j--s M St=F-4' -5-eeC;) • 5 /S--dc> Ls3C),cc '..
L
L .
SOIL DESCRIPTION REPORT
PROPERTY OWNER Page 2. of .J
PARCEL I.D.#
•
Boring# Horizon Depth Dominant Color Mottles Structure D/ft2
9 G Texture Consistence Boundary Roots P
in. Munsell Qu.Sz.Cont.Color Gr.Sz.Sh. -
3 I (MP 10y>'",31 5 IMad, 171Gr. C5 1 P . 2✓
Z tp_n. in yr 5;1 2 rriat)k raci C 5 -_
Ground -5 1 .,/,61 31(e L S Cf)`■C f er14 j C — ✓-
elev.
9ytap ft.
Depth to a Z..
limiting zs2
2
factor
Remarks:
Boring#
i� yrX313 S (Mlbk rncr C )\-C • 3
Z l. f--,3 1(D LS ,ry) w�+ r c - .
Ground
elev.
75C.0 ft. j. 92.5
Depth to 30',`y
limiting
f"T-!r iri.
Remarks:
Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft2
in. Munsell Qu.Sz.Cont.Color Gr.Sz.Sh. h
Boring # (b yr 3 5i1 i rnabk. floc( C ! u C Z;(
5 Z ((yen -)0 y r 31 Co LS
Ground
elev.
(PiCO t.
Depth to
limiting
fact7-7r
'n' Remarks:
Boring# �.ozrn
I O-6? 76y(3/3 — S I zrn �
26-751/ayr3/ ams wt-cr-- .
Ground
( ft.
Depth to
limiting
fac�tgr
7' in. Remarks: jor/.43 dC,6'Q ✓\ - Z —C--)7 SBD-8330(R.07/96) J
• 1
PAGE 3 OF,..3
NAME 5 fa cA-- LOT# Z LEGAL DESCRIPTIONSw 1/4.0.r1/4,S c T,,N,R►Q E(or)e.)
SCALE: 1"= /Z 5—
BM 1 ELEVATION (Cc>- C)
N ,
BM 1 DESCRIPTION Ku;/;,, 34"e/.n wf rig N
BM 2 ELEVATION 70c, • 0 S
BM 2 DESCRIPTION p,.,;/;„ $Po/e u j r/43
SYSTEM ELEVATION ?Z .,SO
t I
4-- _
ALTERNATE ELEVATION ?Z.5-"O K
CONTOUR ELEVATION A///4-
8».t
raw+V
6k
. /�
n 4
M.M a IS rr•• 0
B'ca • 33
Q2 e“--1-. •
5
6
µw
N
PW1.
f occd
SIGNATURE DATE S
L