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Home My WebLink About012-1038-50-100 (2) 5 i _R& i 7 &1r LI Wis. Dept of Safety and Profession ,CEONf E,IL Page ' of Division of Safety and Buildings Os ctr4aNWth SPS -Z .,ooe County Ct ~'!b/~~ Attach complete site plan on paper not less than inches in size. Plan must include, but not limited to: vertical a ~QiA M), direction and Parcel I.D. / percent slope, scale or dimension M tion and distance to nearest road. l00 Please print all information. Review by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Z Property Owner / Property Location / / / A p{- ~mn/ei' Tit Govt Lot / Y/!~v 11454V114 S/6" T _3bN R 17 ■ (or) W Property Owner's Mailing Address Lot # Block # Subd. Name or M# city State Zip Code Phone Number ❑ City ❑ Village ®Town Nearest Road e w P i'ch ^aJ IUT S-Y017 ( ; ~,'e /TO ~f .I t D~L New Construction Use: . Residential / Number of bedrooms Code derived design flow rate ~S0 GPD ❑ Replacement j ❑ Public or commercial - Describe: Parent material r P<<Q p/'ic / Flood Plain elevation if applicable Al k ft. General comments 13ase M p,c.n« m c t, L fit e and recommendations: Boring # Boring ® pit Ground surface elev. .C . 3 ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure onsistence Boundary Roots GPD/ft 2 in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. * ff#1 * ff#2 141A SL 2 ~»yr /nv~r Ccs 2A D, 6 j. D a F-2 C/SYR % 11, S,'4 OnYhk Moe/ c w 2~ D, 6 O, 8 3 ~9 V2 7,00.5i I's 6s? /hL c C - /m o, s /,0 y 112-81 71s_'k 6 S ay Ir v1a O, s-- 1,6) F2_1 Boring # ❑ Boring ® pit Ground surface elev. 607-5- ft. Depth to limiting factor 33 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure onsistence Boundary Roots GPD/ft 2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. * ff#1 * ff#2 1 q /dYR'a'2 If SL .217,yr MOP.- a.S 2,1n 0,6 /'0 2 q zb .5W % IVA 21nJ6k MPI cbu- 21n G, 6 0J 7 26-33 1,S I? 6 IVA ©sf M& C C, /M .s d y 33- $6 -7,,Q9 •~7_6- ~'/FSyR s/ FS 0 s /M L _ ag o * Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BOD { < 30 mg/L and TSS < 30 mg/L CS Name (Please Pmt) Signatur CST Number Address Date Evaluation Conducted Telephone Number 3 9g- / 9oC a v ,~a~ errt~ (.U. s_~4zS_ .3-,2 F- / 7 2- Y7- 3,203 - SBD-9310 (RI ]/1 J) Parcel ID # Page of Property Owner 'Attic 4 x-1402 6 el ❑ Boring Boring # P-1 IS Pit Ground surface elev. O 7 D ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure onsistence Boundary Roots GPD/ft 2 in. Munsell Qu. Sz Cont Color Gr. Sz. Sh. * ff#1 ff#2 &,4 11-4 C,6 Z ,5-YR%y /I/ S;G- In Silt zrt o, 6 O, g 3 2q-Yo 7,1%79 `/6 F/FS~ s? 5Z 1nS-jk /A ©,q 0.7 lv.F 0,S D a Boring # ❑ Boring ® pit Ground surface elev. ft. Depth to limiting factor 1 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure onsistence Boundary Roots GPD/ft 2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. ff#1 * ff#2 0-3 10 z /V* S~ 2 i» op 2M 0,6 /,0 Z s- z 1(1,4 2n sj~,k mfr c U- M o~ 6 c~, 3 2y 6 y 7..sY~f 'F/FS-11 0~ S /lnr,6e ~t{~r c I r~ 0. Y 7 6y 8 1-9.4k 6l& c?,P sYR s F os G o,.57 ❑ Boring ❑ Boring # Pit Ground surface elev. ft. Depth to limiting factor in. ❑ Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure onsistence Boundary Roots GPD/ft 2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. * ff#1 ff#2 * Effluent #1 = BOD 5 > 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BOD 5 < 30 mg/L and TSS < 30 mg/L The Dept. of Safety and Professional Services is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, contact the department at 608-266-3151 or TTY through Relay. SBD-5330 (RI 1111) OWNER Page 3 of 3 Name / c h c/- 4m be.- D,- t4 Brian Parnell Address /70 s't CST 231314 %~tar~lckmo~g WZ SY©/T Date ® Benchmark 1 e- EL, /DO, O A L. Benchmark 2 Bo the on SA e /00.0 ❑ Soil Boring i_J Suitable Area l" = 40' Scale -~___1 -1__ H l i R I ; ! f f 1 F ~ I ! i 1 t i q$ f I I I f IQ4 IT[ -Ulf 7 a f 7R 1 1", Y 10 V it, f e i O ► v ~ i h r ~ t t ► i E ! / ur t