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HomeMy WebLinkAbout032-2174-18-000r 1 I 1/ Wisconsin Department of Commer R "C • EVALUATION REPORT Page I of 3 Division of Safety and Buildings E�V D in accordance waft-Corn 85,Wis. Adm. Code County 5, (4o i/ Attach complete site plan on pap r not I @arl8R/2 nche•'in size.Plan must - include,but not limited to:verb.; and horizontal re`rer� oint M),direction and Parcel I.D. percent slope,scale or dimensi• s,nQ ,and location an. distance to nearest road. O3a —02/ 7 y—��- .) �f�C COUNTY Plea 111-1 lfifOr m ion. Re '-wed bil Date Personal information you provide may be used for secondary purpose .rivacy Law,s.15.04(1)(m)). I O y Property Owner Property Location 2U tin 73e/j f k Govt.Lot 5 1/4 iii /4 S 27 T 3/ N R 19 •(ore Propeq Ow er's Mailing Address Lo)#,S, Block# Sub�d Name or CSM�#1 c.,It_ R/4e City State Zip Code Phone Number ❑City ❑Village Ig Town Nearest Road 50(ne, 9- 1 A- l Sb2S 1 (7/..r )2V7-325y ,*)in ,-se;i- I f7 slzf New Construction Use:[. Residential/Number of bedrooms Code derived design flow rate ‘er el GPD ❑Replacement ❑ Public or commercial-Describe: y� Parent material Flood Plain elevation if applicable /Y ft. General comments / 1 and recommendations: Sis i', �`P S 7 7 il �� J B I Boring# 0. Boring / ® pit Ground surface elev. /�S1 3 ft. Depth to limiting factor <6 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. *Eff#1 *Eff#2 1 0-7 /g-/- Am- ,ii- 2msm "A r C w 2/9► 0e s 4. 9 Z 7- f 9 /D!'/(q 7rit $ - 2/9'1bic vq:,r c 4-' 0. S 0 o q 3 1g-30 /0fi % N4 5l . 2/2),- ,‘, ,n,(r cs //1 OS C. 9 • Y 3o-64_�z i /v4 /G s" /rzssir., m z as /v4' 0, -7 /, 2 . S----a-75- c WK C?P s rR 4'7"44 5, OA" }37 , -- D.0 O 2 1, /3. / ‘oy -3. I ‘ , 2 Boring# ❑ Boring / I . Pit Ground surface elev. 0,3 ft. Depth to limiting factor { 'd in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. *Eff#1 *Eff#2 1 6.-9 /©y'�4 VA S4. 2ms6le At L/ c C w 7ni 0, 5- O , q Z 9-2 / / ' M%y N A 5z- Zrsx t- ' 6') z Ph 0, S © r 9 3 27/ /VA GAY /r -ii '- a, Jr 0. 7 1 , a Li 6-7y SY� %/ ceps X1f,50fr2. 5 6.c/n it & 4s hi 0.0 0 .2 5 7y tip-ins-t©.c . *Effluent#1 =BODS>30<220 mg/L and TSS>30<150 mg/L *Effluent#2=BODS<30 mg/L and TSS<30 mg/L CSTAlame(Please P' t) Spnature CST Number JSr a.e• T4 r�.e // U /2- Z -�3 /3/ i7/' Address Date Evaluation Conducted Telephone Number 378- /92. a.ue _SD14e/3-c r- et.,2 l2- /3-O3 7/c-2.97- 3203 SBD-8330(R07/00) • / Q ,4 Property Owner &Pt Be/'.f iG Parcel ID# Page 2 of QBoring Boring# Oa. IA- pit' Ground surface elev. ft. Depth to limiting factor <Sz in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. *Eff#1 *Eff#2 I 0-9 /jj`/1h Al4 Si- . msA P u1-c Ci, - 2hz O.s 0 y 2 Q-20 / �'i�{ `/V 4/A- 54 2/W4 f 4 o F, cc- 14. O. S © , q g 2o- 2 Zr,€ i w✓, 2/kilt Ap f• / 0,s- o, 9 3Z- cz 7c/R % #4- SL 01'•15 � ,/C y" / ') /L, 0, y O, $_ s s-/X Yiy C2/ cr4 7/z s;iu Gc 2-(ii ), o 0 , a 6 is-Y) /oyq i3 met 15/4,b 0-(1/k) h a, 6, 6 7 L;me.r1'64e Boring# ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. "Eff#1 *Eff#2 II Boring# ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. *Eff#1 *Eff#2 Effluent#1 =BOD5>30<220 mg/L and TSS>30<150 mg/L *Effluent#2=BOD5<30 mg/L and TSS<30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format,please contact the department at 608-266-3151 or TTY 608-264-8777. SBD-8330(R.07/00) ?aye. 30 3 yO\N/NEF r gjt Name 76� hi/e ^i- 23/3/5/ Address �Sf 67a'- /9z a0z _5-0 rie%er- 6-}•T ,JYOZ.s" Date /2- 0-03 Benchmark 1 /CL, /UOO O /.,-, ,-- ar-.-. .,✓: -C ..LL, Benchmark 2 �, /e3./5- A/ / . 4 co-5.71- ,S' f, �o7Lcot-tf". l Soil Loring 1-j S Lu[acie Area 1" _ 40' Scale 1 j i ! } 1 j l iI I! I i 1 1 — -- j I r i I i i i ! j ! I I i •i I ' j i _--.. ...-----------"—T i 1 T j 1 1 . ; j i 1 A\ i -- . ------- — -- ' ; i ,t Y; � ; p� i 1 ,';A i i I i� If /'��� I ' i ; 1 i , 1 I I ' i 1 i i f ! I i p • ! : i ; I , ! 1 1 ! i ! i j i 2 1 ) I 1 I EIHIT , I I i II ' _! \I j I I I t T F/ : i ! 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