HomeMy WebLinkAbout032-1065-50-150 (2) :visconsih Dapprtment of Commerce SOIL AND SITE EVALUATION
Divition 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 8j' e. Plan must County
include,but not limited to: vertical and horizon ) di ion and r
percent slope,scale or dimensions,north arro catio and dis exo earest road. Parcel I.D.#
® . °� o a -i ate"-50 l�
APPLICANT INFORMATION- P/ print a mformation�rte' Re ' wed by, Date '7isn t—
Personal information you provide may be used fo nda see(1vai�w,S.1 1)(m)).
Prope ner CO. S_ G9JDUk perty Location QC
_ ovt.Lot 1/4 N,R E(or
P party Owner's Mailing Ad ress ,A N J,Lot# I Block Subd.Name or CSM#
r� u1
11 I
ity Stat zi a Phon �N
❑ city ❑ Village Town hearest Roadf �
(OD9nstr Use: ❑Residential/Number of bedrooms Addition to existing building
Replacement ❑Public or commercial-Describe:
Code derived daily flow gpd Recommended design loading rate bed,gpd/ft2 trench,gpd/ft2
Absorption area required bed,ft2 trench,ft2 Maximum design loading rate bed,gpd/ft2 trench,gpd/ft2
Recommended infiltration surface elevation(s) ft(as referred to site plan benchmark)
Additional design/site considerations
Parent material Flood plain elevation,if applicable ft
S = Suitable for system Conventional Mound In-Ground Pressure AT-Grade System in Fill Holding Tank
U = Unsuitable for system ❑S ❑ U ❑S ❑ U ❑s ❑ U ❑S ❑ U ❑s ❑ U ❑S ❑ U
SOIL DESCRIPTION REPORT
Boring# Horizon Depth Dominant Color Mottles Structure GPD/ft2
Texture Consistence Boundary Roots
:: yi in. Munsell Du.Sz.Cont.Color Gr.Sz.Sh. Bed ,Trench
Ell
�? 41, s
Ground
elev. r >
ft• - / _
Depth to
limiting
facto
� in. ,
Remarks:
Boring#
Ground
elev. '
/l �12ft•
Depth to
limiting
fac or
> in. Re arks:
CST Name (Plaa6e Print Signet — Telephone No.
Address �� D to CST Number
•
• •
is -•• • • Mottles ®®®®�
s• • • ♦' • • ••1.
IIIII�I�IA
Dominant Color 1� motfies
• :• • ••I.
110
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'97 ,
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