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r.Oconsin Department of Commerce SOIL AND SITE EVALUATION
Division of Safety and Buildings Page of
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 , C'col V
percent slope,scale or dimensions,north arrow,and location and distance to nearest road. Parcel I.D.#
,. - 0 3a-. D-1 d-t f -- g-too
APPLICANT INFORMATION- P/ease,pK nt�a�Il�ififbrrria^tip►"?.. Revie ed by Date
Personal information you provide ray be used for seF4ndary purposes(P acy Law,s.15.04(1)(m)). '. L00
Property Owner b 1 •. _' Property Location
icgli 4111 f r F Govt.Lot �CA..) 1/4 ,U 1/4,S j T ,N,R i Ct E(or 1N
Property Owner's Mailing Address . Lot# Block# Subd.Name or CSM#
13S.3 � l -1L Tr . _ 5 ChaLire
City State Zip Coda .PhQtte Nur"flb r- ❑ City ❑ Village M. Town Nearest Road
g yaEl74nd
#L 1 C f-j a l n cwt 1 X7/5 -1?31 3e - I , �.- , -�.
New Construction Use: Residential/Number of bedrooms Addition to existing building �i _ '
Replacement ❑Public or commercial Describe: (Ii Se�/ y' � /y� S(� .//V/�i[�� ry
Code derived daily flow 60C) gpd Recommended design loading rate '7 bed,gpd/ft2 • g trench,gpd/ft2
Absorption area required 65"7 bed,ft2 7 3-0 trench,ft 2 Maximum design loading rate *-7 bed,gpd/ft2 , 8- trench,gpd/ft2
Recommended infiltration surface elevation(s) 9'(O . r!' z- ft(as referred to site plan benchmark)
Additional design/site considerations /4-G I. c It a. �G. 6' z-
Parent material 71" •' / I Flood plain elevation,if applicable /rte - ft
S = Suitable for system Conventional Mound In-Ground Pressure AT-Grade System in Fill Holding Tank
U = Unsuitable for system N I S ❑ U V S ❑ U S ❑ U E S ❑ U ❑S U ❑S [ U _
SOIL DESCRIPTION REPORT 014„ GIJ
, CO*
Boring# Horizon Depth Dominant Color Mottles Structure GPD/ft2 I.
g Texture Consistence Boundary Roots
in. Munsell Qu.Sz.Cont.Color Gr.Sz.Sh. Bed , Trench
OHO- (byf 3)Z� 5L I mabk rr)Cr CS )1/44- • `( ' -S •Y
1p-toc •( yr 3)69 L S 1 irr) 5 mCr c 5 _ \>6N .I.
Ground 3 ,
elev. �'lnyrLit(D rn S n.j mC c5 g
/01.32 ft.
Depth to
limiting
factor
( in:
Remarks:
Boring# ) d II I0 y fil Z Si_ ( ma k h ,r C- :� 4
Z Z 9-43. (o yi3�(c L i m` ,-Y-)Cr L5 -- ` . ,1
3 y8-Ii •I cry f L-1 /4 vn 3 o ml
Ground
elev. .
/o0Az ft. 0.+ 94.6z
S6-y"
y„
Depth to
limiting
factor -
Utz, in. Remarks:
CST Name (Please Print) Si 1.ture Telephone No.
nt)pryn 3(*,(..5rytv.ve_-, ,
/
Address Dae CST Number
Z 1 l3 1'' �-- Sory-e ec 57/D2.c �5 t t sue Z 533,0
SOIL DESCRIPTION REPORT '∎'.
PROPERTY OWNER Page Z of 3
PARCEL I.D.# olJ new
code cod,
Boring # Horizon Depth Dominant Color Mottles Structure D/ft 2
Texture Consistence Boundary G Roots P
in. Munsell Qu.Sz.Cont.Color Gr.Sz.Sh. Bed ,Trench \l,
3 I a-+4- in y(3)2. Si_ 1 rnabk inCr cS l vc .t-t-:- ,5- . '7
a P-t) • t y( 31(() -- S - /
Ground 3 rte-lit'in /( I 1 p r x`7 (') j nil t 6J — -1 - ' 7
elev. J
JCX.6-e-ft.
Depth to 4' Q`.X02 - - —
limiting 6.,1`.%.67,,factor — — — —
I1 )in.
Remarks:
Boring#
`! I o- - ' In f-,3)2. "-.3i' I _ 1mabk m-4c c 5 }�C - 2 -3 , 2
2 151 • I b ir-31(0 US I mSi. 1 '( c 5 — .---i .7
Ground
elev.
t'04)•6L ft. e4 Qt.(Z
/
Depth to .
limiting
factor,
1-in.
Remarks:
Horizon Depth Dominant Color Mottles Structure [ode
Texture Consistence Boundary Roots GPD/ft2
in. Munsell Qu.Sz.Cont.Color Gr.Sz.Sh. Bed , Trench .i
Boring # b lc3y(3(2 sir rylrl r,-)Tr <.5 l v-V -2 • 3 '1
5 2 2-zo • (6.1( (-I3 3 i 1 21-r, xhk no-Cr c 5 w - S
3 gar LS I1 I i c-S - ,1 ; , t ,I
Ground
elev.
(or It ft.
Depth to -
limiting ,
factor •
in. Remarks:
Boring # Kruk rat
j c-iO '10yr3/3 — S;l 61.14bk_ .y?1-f- C S • ff
6 Z 0-zz! -/Ov r /� Sic ( Zmgh k 01-Cr- ,‘/7/ /6,
3 OOvi-telDyr 3//6, 2 ,sb,6 Yri-c r \` .S ,9
Ground 471 /d, /rD)/!' ((� — Z_ 5 /int . m I • `7 ./7
el 4 v.
N7 ft.
Depth to
limiting
factor n
tin. Remarks: Bev/et y c a o vt Z Z -0/
SBD-8330(R.07/96)
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PAGE 3 OF
NAME .Se's- LOT# 5 LEGAL DESCRIPTIONW '/4sc,//4,SS T so,N,R q E(or)60
SCALE: 1"= / f
BM 1 ELEVATION (
BM 1 DESCRIPTION 1 1‘
pup z pow p;Pc la#k ,„JFI«cJ.
BM 2 ELEVATION (CO • d S
BM 2 DESCRIPTION 4,P z Luc,p;pa to.-th'J/r iu5
SYSTEM ELEVATION ?Ct.6
4 _ (—
ALTERNATE ELEVATION q6
6
CONTOUR ELEVATION 44-
• $L p,;r^..1{09
0dtixB •
SIGNATURE ���% a { t • , ,'� DATE 5--/.5 CD O