HomeMy WebLinkAbout032-2174-04-000 (2) .
I RECEIVED
Wisconsin Department of Comme E ALUATION REPORT Page 1 of
Division of Safety and Buildings DEC 1 8 2 U uj L
in accordance with Comm 8 ,Wis. Adm. Code
County ,51. _k7,01 Y
Attach complete site plan on pa•= not le r uall i)1/� a iplehes in ize.Plan must
include,but not limited to:vertical-•- ••....:.rk1l=, 1.__,:,int B direction and Parcel I.D. 1 ,!
percent slope,scale or dimensions,north arrow,and location and distance to nearest road. 3.-�,/7 c •�D L/' )
Please print all information. evie Date(iy Personal information you provide may be used for secondary purposes(Privacy Law.s.15.04(1)(m)). a
Property Owner / Location
j .E S4 Govt.Lot -; 1/4 1/4 S ,?T,7/ N R/9 (or
Propsrty�Owner's i Mailing
92��Address,/ Lot#j Blo # St�d.,'Narne or 6811#
j ,:t2 1.'. --
City State Zip Code Phone Number 0 City ❑Village 0 Town Nearest Road
— e i l,.e S E 7/ I filf.t I ,5` 1 ( ) .2.12,,2,.�vok 71-- I 5 7'x-5"1
-New Construction Useja Residential/Number of bedrooms ,?- 5/ Code derived design flow rate -/ D- / D GPD
❑Replacement ❑ Public or commercial-Describe:
Parent material Flood Plain elevation if applicable
General comments 4//, ft.
_3:53 4;.. ...x1 /64‘5:&9 es, )tie L.C. is f 1 �i/sez,'+� // at ` D
and recommendations:
I Boring# r0I Boring SAO'
/ tar Pit Ground surface elev. ft. Depth to limiting factor .-?. in. Soil ication Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff°
in. EMunsel Qu.Sz. Cont.Color Cr.
MISz.Sh. •Eff#1 •Eff#2
IIMINFAIMPMENWAIMMIONFANNIMMIPMErMINEMILIN
ErliNAPAPPPM„ . _ .ilRMENIMI
. 111Mil . — — =»
Boring# El Boring
=X Pi
41 t Ground surface elev."D/},0 ft. Depth to limiting factor -?/ in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/W
in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. •Eff#1 •Eff#2
r / . „, , l .� 0
Minya tl/{a7"�AMI f M Itll.'!ra'.titl■ - =MI
•Effluent#1=BOD5>30<220 mg/L and TSS>30<150 mg/L •Effluent#2=BODS<30 mg/L and TSS<30 mg/L
CST (�P � (�i✓LGIIug ro � ,r/
Atidrrass . Date Evaluation Conducted Telephone Number? -g! M.- 6. 'e
r 0/'�?et e /- l✓f',J Z-13 -6I 7/3"-2V732 ee
. ` / �eI
Property Owner A i S I DI Parcel ID# Page �of 3
2 # ❑ Boring `
N Pit Ground surface elev. Depth to limiting factor -..._?Q in. l Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff
in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. *OW 'Eff#2
6-
? '7-za `,`x'y 4 ✓ s ' 1 L 9
1C-ii,. .ii,ney* ./.7.__50 , -.4e-fg,_,1,404 ..141 ef,:. Aga 1:: -- '----- I o I C,2
Ong# ❑ Boring
❑ Pit Ground surface elev. ft. Depth to limiting factor In. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Stricture Consistence Boundary Roots GPD/ff
in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. 'Eff#1 'Eff#2
# ❑ Boring
Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor In.
Soil Application Rate
Horizon Depth Dominant Color Redox Description. Texture Structure Lure Consistence Boundary Roots GPD/ff
in. Munsell Qu.Sz. Cont Color Gr.Sz.Sh. 'Eff#1 'Eff#2
•
Effluent#1 =BOD5>30<220 mg/t.and TSS>30<150 rtg!L 'Effluent#2=BOD5<30 mgtL and TSS<30 mg/L
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s8D4330(L6/00)
,
OWNER Page 3 of 3
Name
o,„ DELI- Brian Parnell
Address CST 231314
Date / 2- i?" os
Benchmark 1 iv �OD.� 7 p 5 E I- Co/.4 e, - &
Benchmark' �L, /D 2' 7 #o,./ Sig post ex ,S� Co/Lc-0,-e-
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•OWNER Page 3 of 3
Name Brian Parnell
Address CST 231314
Date 1 2— /?-- c..)3
,,:.. .- Benchmark 1 t-I. /a)'6') 'WS't‘0 i- cc/4C'
....:,.....`, Benchmark 2_,.
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l" = 40' Scale
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