HomeMy WebLinkAbout032-2126-20-000 r
> scon;`Department of Commerce SOIL AND SITE EVALUATION
•[vision of Safety and Buildings Page of
Bureau of Integrated Services in accordance with C.- .;• _Wis. Adm. Code
Attach complete site plan on paper not less than 8 1/2 x 11 inches in • :` pn must County
include,but not limited to: vertical and horizontal reference point(B •i •cttion Of t�- 31 (-V V -, (
percent slope,scale or dimensions,north arrow,and location and d• . e to ne r Parcel I.D.#
APPLICANT INFORMATION- Please print all information. �' Revievted by Date
4:_
Personal information you pr ide may be used for secondary purposes(Privacy Law,s.15.04(1,),,( 4;47-.,
� /�� �� /Q2y � 3/ ZOO
Property Owner i�rdp +Lisz ra ,�`
((
1 • � �� Govt.Lot ,::/1/4 54/1/4,SS T..cf,N,R /C.( E(or)0'
Property Owner's Mailing Address Lot# Block* Subd.Name or CSM#
i35---- >) )0( . E -- z CV,i►bQ F
City State Zip Code Phone Number ❑ City ❑ Village , I Town Nearest Road (-704
\o'er i I serf Q I6 I (715 )sew- 47 i zowve-Qa c-,(=r I c./Ld, '.-t.� X5 Sy
New Construction Use: Residential/Number of bedrooms 3- I Addition to existing building
Replacement LI Public or commercial-Describe:
Code derived daily flow Cor v O gpd Recommended design loading rate '.S bed,gpd/ft2 - G trench,gpd/ft2
Absorption area required 62 a ) bed,fthO r..3 d trench,ft2 Maximum design loading rate- bed,gpd/ft2 • Co trench,gpd/ft2
Recommended infiltration surface elevation(s) /00 S' ft(as referred to site plan benchmark)
Additional design/site considerations GO!)-f//cit Tr CI Q` sv
Parent material 4i' ( ( Flood plain elevation,if applicable /0,41 ft
S = Suitable for system Conventional Mound In-Ground Pressure AT-Grade System in Fill Holding Tank
U = Unsuitable for system ❑s R u 17 S ❑ u ❑s ® U ❑s 01 u ❑s in u ❑s o u
SOIL DESCRIPTION REPORT
Boring# Horizon Depth Dominant Color Mottles Structure GPD/ft2 w
Texture Gr.Sz.Sh. Consistence Boundary Roots
U#
r frY Y..,, in. Munsell Qu.Sz.Cont.Color Bed 'T:- h ud1,
.: 1 g i - ? /d y`2_ 3y SL ZmabK wwo.. a k,, - S 6 .�
-Z 8-'1-4 0 vn ` L.5 �r',SJ y 2 CS Ss .1.
Ground 3 ' 21-36 l6 yR. 3 6 f z�7 5y2 y/(j L5 3v ■ 1 1r -S — ,1
elev.
/Do ooft.
•
Depth to
limiting '
factor
`2`l in.
Remarks:
Boring#
\ . O-w to Y2 31 4 s ,1 , 7 4br\ TcL c-S \L/T- 5 i 6
a.:. 1 z 1 10 pl. ITS 51 2. -a►-, c2 cc — 5 . 6
3 - ZK 36 fb y rt 1 4 C--vv .7-.S yti It S t 1 Zim..4,13 c w c i C5 — 5 . G ,S'
Ground '
elev. •
(76 loft.
•
Depth to '
limiting '
factor
"ZY in. Remarks:
CST Name (Please Print) •ture !, i Telephone No.
Address Date CST Number
2i k .t " ' ---5-- 3 4.1. JP _1— _ .l 0)60 0 Z
1
SOIL DESCRIPTION REPORT t
PROPERTY OWNER Page of
PARCEL I.D.#
Boring# Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft2 kt W
in. Munsell Qu.Sz.Cont.Color Gr.Sz.Sh. Bed Trench Wt.
1 0-g to '5► q 51' Z bK CS F 5 6
2 '11-2.6 le r 3/ ( SL 7 t,e,,nbV, v rx_
Ground • a-34 lo yy� ► 4 ( .S y_cz 41 S t, LM Abk 4✓t r, LS - S G 5�
elev.
/CV colt
Depth to
limiting
factor
'Z-6 in.
Remarks:
Boring#
gAITA
2
•
•
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#
Ukitz
Ground
elev. •
ft.
Depth to
limiting
factor
in. Remarks:
Boring#
AnSit
rEind
•
Ground
elev.
ft.
Depth to
limiting
factor
in. Remarks:
SBD-8330(R.9/98)
w •
PAGE 3 OF_?j
NAME S t •tAT LOT#Z•Z LEGAL DESCRIPTIONSw 1/4941/4,S S Tao,N,R IRE(or!WW)
SCALE: 1"= (0
BM 1 ELEVATION l00. 0
BM 1 DESCRIPTION{c,e4}.g,`puc eve t,41-kv/i-Ja
BM 2 ELEVATION /CO• Q 5
BM 2 DESCRIPTION}of 04 I i„pvc opt, (G.+k&.lfIa`3
SYSTEM ELEVATION (OC.) •SD
ALTERNATE ELEVATION
CONTOUR ELEVATION 11• I
V% 4.9-5 no
Tv: o
OL�t
• •
a3
a1
SIGNATURE DATE
1