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HomeMy WebLinkAbout040-1104-40-000 (3) DECEIVED P A I I �( ,a X14 j 3 Wisconsin Department of Cocec J SOIL EV PORT Page of Division of Safety and Buildings TY S,.C.r .1(Cq with Comm 85,Wis. Adm. Code County Attach complete sitlaper not less than 81/2 x 11 inches in size.Plan must include,but not limited to:vertical and horizontal reference point(BM),direction and Parcel I.D. percent slope,scale or dimensions,north arrow,and location and distance to nearest road. Please print all information. Re.KWed Y _ Date Personal information you provide may be used for secondary purposes(Privacy Law,s.15.04(1)(m)). / Property Owner -^� Property Location �( /L r��t ) � 1/4*5W 1/4 S �6T aZ(F N R F'kW)W Property Owner's Mailing Address Lot# Block# Subd.Name or CSW 1/0 S-111 f4 -/-At,v rt -- City State Zip Code Phone Number ❑City ❑Village Town Nearest Road Soo a� Rd ,vcr ❑ New Construction Use Residential/Number of bedrooms Code derived design flow rate d C7 GPD Replacement Public or commercial-Describe: Parent material to e ss Flood Plain levation if applicable ft General comments S i f f Qdd•c s j ,'s R.d-al and recommendations:7�i,!� s. 7�e u..!/'C�ci. ►'C 4 .�o a s/e u c 2 1-4e m a.L�i" a' Sgnl:. A1/ � (?,/OwJ'NC Q�•"ttr. iw9'iart CG l �f7 T�LC7`�> /,4 rlcs," ti ol3,yC �cS- a Boring# Boring 9'6- Pit Ground surface elev. 1� ft. Depth to limiting factor �-3 in. Sod Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDlff in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. 'Eff#1 I -Eff#2 3 /,5--.23 /v + ssi— �aLIC •- 'r' w l v� a-6 a-�3 t7-7 z3 �" p p 7�s" ,�s t,C(, a ® Boring# Boring Pit Ground surface elev. ' ft. Depth to limiting factor 33 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fP in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. *Eff#1 -Eff#2 s ,2 (:-6 �- a 41/3 - s.z L .2 �,a.6K` fin" �' -2 {' C%,6 /,*7 .Q cw v 0- 7 /.6 S -5"0 10/119 u W$ o M d-J? -' -d C'- "Effluent#1 =BOD >30<220 mg/L and TSS>30:5 150 mg/L 'Effluent#2=BOD <30 mg/L and TSS<30 mgtL CST Name(Please Print) Signature CST Number cti a /r s the-6;-tej, 11© 6 7 3 Address G --5-� / Date Evaluation Conducted Telephone Numeber 51C l.2 0 4 } N (7 / 7d �j st ��15 Wo rf/l WS G Property Owner u--U" R t f a"" z Parcel ID# 040—YO-4 4 Q—c>o o Page a of ❑ Boring# ❑7r Boring U 1Z Pit Ground surface elev. �s ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDffF in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. 'Eff#1 "Eff#2 l 0-// /z- 5-Z L .Z a s' !-17 /v Yof t/ — sT 4- .�4 J y mac. r 2 0.6 0 17-.;-13 1 b f L - S 9 QS 2 it o.7 A t" 3- �S` -- S s L w — O_7 A tS S z v Y-f l 1Y1 - ❑ Boring# ❑ Boring ❑ pit Ground surface elev. ft. Depth to limiting factor in. Sod Apffication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDW in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. 'Eff#1 'Eff#2 F-1 Boring# ❑ Pit Boring ft. ❑ Ground surface elev. Depth to limiting factor in. Sod lion Rate .Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDNF in. Munsell Qu.Sz. Cord.Color Gr.Sz.Sh. "Efl#1 'Eff#2 I Effluent#1 =BODS>30 5 220 mg/L and TSS>30<150 mg/L 'Effluent#2=BOD.,5 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. M4330(R.07 100) Y UA//VEK rI T r oF' Gvj.rconlS/,h( Rlv /4 FAc(S � a. 04o/-/Jof - +C) - 000 -4. f V O O (L A a i"4t Iltz to e-/e v J d =ol, j d ax,'rr��� ►/ Stpr•'C ta.tk u S��e thGJoycr Rd � w �n�Ka,!•h tv a 11� i bokt.f b.re. i rvuw W. 4ekVe IOaO f 97 0 '1 6 •l CIS- (72 to C)0 4 0 o� i y �[ N cw o.v O C C U 0 0 O w T N-0 N III N o O Y t o. fi N C 0(0 _FL 3 3N N� h N 'O-6 y c o 0 c � p � t0..a N ; °"'-'.0 ° 2 c O2 m— Q y ((._ —`Q c-Q Q._ a) cowc N 3 N N T C zt —° o v �om ; o a.� �N Er .0Z E 0 o Nn ti L" c CL — " 003 No 0 aci ° T N N N0,I,Z CN'O= a) 7 m O? c O;yONti � o Z € 0?a° NYU) Ev' o II' m 0-0 0 c`� �_� ov E LL C U O)_ T0-. D. T (D 0 Y V •�C O _� O O 'o N E co co QN y o 0 a)V >. N 7 0) Or+ L�JO N 1 CD I Z iLL E 0•' ao c L Z ;.; O 42)Y I V > `O t 02 4 p O ) a a N € d m v3 N F CO O TL N LL d c- O.O c6 o z J L v MD D U y a0i z d c tonE CO) r CD E > o U) 0 m c m ° c Q N la 7 Q E N N N N --t N "06 O L co d CD c O N O 00 O O O Z Z Z Z NI 0) (D - N a l +�+ m N m U cc O d E y h w p f6 N U) t/> WJ � N a = •� Taaa N _ CL S? as O N o 0000 coo Q N J U c Q) c Z Fl- o v v cc v N 0 0 0 0 0 - O E N N N N m G a co M C rnN 0 .- � azin o ^l O p N C C> O O � co p Cl) I� rO p 00 toq U) E 0 4) N N N N N v � ° m G N 2 C 7 N_ M e d ~ LL N N Z '0o C_ N p M LO I T 0 ~ N O �O N E O 0 U • e O N I- O O z N H Z fn V m € a ` ate • � a c, .� d o c