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Bayfield County
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?u ,'024 Soil Test #^_
(subject to 15-1-10(d))
I, /^ll.Q.i/l fO/F^-OS/C,^ _ a certified soil tester determine that in my professional
judgment the following site (see below) is unsuitable for any treatment component other than holding
tanks. Due to soil & site conditions, a thorough soil and site evaluation is not needed to make such a
determination.
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Property Owner ^ ^ ^ ^ <^^i/ S Li ^ "^ /c^ Contractor.
Property Address / 7 ^~^ 7>^ ^<^' (^- <L Authorized Agent__
Agent's Telephone.
Telephone ^l ^ -cr<7 ^ f 5 / ^ _ Written Authorization Attached: Y or N
Accurate Legal Description is requested:
^^ 1/4 of ^/e=1/4 Section 7 Township ^ N. Range 7 W. Town of_^__(_i
Additional Legal Description:.
Govt. Lot Lot Block Subdivision
Lot _ CSM#_ Vol. _ Page _ CSM Doc #
Volume_Page_of Deeds Tax |.D#_Z_^_z_f__Acreage ^ ^
Indicate reasoning for your determination: C<) ^\~ <^ i <* y^ > s £y ( t — /^ ° o + ^-€_r-
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Signature of Certified Soil Tester
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Date
C^T 2.Zooc\o
Certification #
Signature of County Official
(Submit a Plot Plan & Fee)
Date
u/forms/soiltestwaiver(KLK)
June 2018
(M $SC 5'30^'J ^ ,