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ST. CROIX COUNTY
WISCONSIN
ZONING OFFICE
1 s d u q - rrAr ■r ST. CROIX COUNTY GOVERNMENT CENTER
1101 Carmichael Road
• Hudson, WI 54016-7710
Y (715) 386-4680 FAX (715) 386-4686
Page of
COUNTY ON-SITE VERIFICATION FORM
Inspector: klLrl a-- l~ct~a,~,•__ Date:
Parcel ID Number /,,6.., w ,
Pnoperty&,mer PropertyLaation
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Property O wner"s rvlai inWdress Lot Block # 5rtd. many- or CSk#
Z 3-0•`' eS
Gigv State Zip Code Phone N umber ❑ City, / ❑ Village c, In Nearest Reed
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N_wconsttuction Use: ❑ Fwsidential F number of bedrooms . _ Code derivcd dcrign fis,rate__.__. GPD
❑Replaoement ❑ Public or commemal - Describe:
ft•
Parent material Flnod Plain elevabon it applicable
General comments /
and rxcommendations: OAS p
❑ Boeing
El Boeing
❑ pit Ground surface euYti. ft. Depth to limitim factorin. Soil Application Rate
Horizon Depth Dominant Cobr Redox Description Texture Structure Consistence Boundary Roots GPafr
in. Muns€l l Qu. Sz. Cont. Cola Gr. Sz. Sh. 'Eff#1 `Eff*2
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Conditions: 1f c.t Wei{ I.;tl d
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Soil Survey description:
Notes:
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