HomeMy WebLinkAbout004-1053-60-000 w f7 '
Wisconsin Department of Commerce IL LUATION RK Page / of
Division of Safety and Buildings c,
in accordal&D G�
A r&Q 4 Wis. Adm. Code
County '
Attach complete site plan on paper not less tharMQR0JXtC1ftN e.Plan must
include,but not limited to:vertical and hori f n and
?�:�'I�itG �t @+�ia1�l�;�p Parcel I.D. p O O
percent slope,scale or dimensions,north arrow,and location and distance to nearest road. �D�l0 j�_,g D
Please print all information. Reviewed by Date
Personal Information you provide may be used for secondary purposes(Privacy Law,s.15.04(1)(m)). (� iN S Z7-
Property Owner Property Location
Govt.Lot ,5 6 1/4A/6 1/4 S,.3 T N R /5— E(o 1111
Property Owner's Mailing Address Lot# Block# Subd.Name or CSM#
City state Zip Code-? Phone Number ❑City ❑Village . Town Nearest Road/ Z60
�t' Steyr (,�.0 JryUc) ( (71J ) 7a 4�b 4:: ^ l 521rt1�
❑`�New Construction Use:❑ Residential/Number of bedrooms —3 Code derived design flow rate ��y GPp
B-f eplacement ❑ Public or commercial-Describe:
Parent material n -jZ oUe&- Flood Plain elevation if applicable ,Vi ft.
General comments
and recommendations: ". /Sr�p,— ,�S' � Q A
IC 0 1 G' J
I Boring# ring y� �
pit Ground surface elev. ft. Depth to limiting factor in.
Soil 6pRlicatlon Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots D/ff
in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. "Eff#1 `Eff#2
r -.2 j D l� v�S t 1 -- 1 / r
Boring# F j Ing
f__3 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/ff
in. Munsell Ou.Sz. Cont.Color Gr.Sz.Sh. "Eff#1 "Eff#2
r) SIT PA
3 - 30 0 -5-11 IN
_T_
i
Effluent#1 =BQD >30:5 220 mg/L and TSS>30<150 mg/L "Effluent#2=800 <30 mg/L and TSS 130 mgtL
CST Name Please Print Signature CST Number
Address V Date Evaluation Condilded Telephone Number
Cyr yes=/5--
Property Owner D'e I ��� j ' �5 °L-`, Parcel ID# ��`/�� S� c� Page a of
7 Boring# 0 Boring
(9 pit Ground surface elev. ft. Depth to limiting factor a in.
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. "Eff#1 'Eff#2
6 e o yk s .� c s `, 0
L- Q uJ /
Boring# 67P ring it Ground surface elev. ft. Depth to limiting factor %�� in. Soil Application Rate
I Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF
in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. •Eff#1 'Eff#2
I
Boring# ❑ Boring o D
❑ Pit Ground surface elev. O � ft. Depth to limiting factor��in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM
in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. 'Eff#1 •Eff#2
r, -bk frn� ) t- 9
-YA S C L
'Effluent#1 =BODS>30<220 mg/L and TSS>30<150 mg/L Effluent#2=BODS<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.
S131)8330(R.07/00)
Property Owner 6 O�; Parcel ID#_OO T �0 ,� '�(�— (L70 Page 2--of
F6_1
Boring# 0 Boring C7 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/fP
in. Munsell Qu.Sz. Cont.Color Gr,Sz.Sh. 'Eff#1 `Eff#2
Pic A;-+ . S �
c b r
I
Boring# orin
g
In Ground surface elev. ft. Depth to limiting factor in.
Soil Application Rate
I 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
vk
i
UBoring# VEIB ing Ground surface elev. s ft. Depth to limiting factor $ in.
Soil Application Rate
jHorizon minant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff
Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. 'Eff#1 'Eff#2
S '5 2 r✓l ,jL t t J t O
`Effluent#1 =BODS>30<220 mg/L and TSS>30<150 mg/L "Effluent#2=BODS<30 mg/L and TSS<30 mg/L
'I'lie 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.
SIiD•8330(R.07/00)
I
� o
Cc' RAJ 7:
�l FL
x
4- ft o
14,IC-y Sec
/v e be/c,
It-no
d
4o.5-e Sjj-j�
1-0
r •
-ren P 4,4 Z E
4/
-S I
R6Lb
►
-Top puc ptp�
-rop of I-q" POC 'A-551r�, P-16o
SOIL PROFILE DESCRIPTION
Owner: UGC 1�jG � 2 CST: (3EAIN16 �'�-G �''�
System Elev. Proposed: W-65-ft Syst. Range ft to ft Ld Rate:
# Z Elevation: f< # 3 Elevation: 9y Z # Elevation: 93 iv
o Boring o Boring o Boring
o Pit o Pit o Pit
9�
9y
__--- ----- -_--
Qo
S8
----- ----------- -----
---- ----------- - -