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HomeMy WebLinkAbout76-24..^ r^/W'-i^o • i ][ ii \/^ .';./ Soil Test # Bayfield County Waiver of a Thorough Soil & Site Evaluation (subject to 15-1-10(d)) i, ^ii^fA rs> / f<-os K. i ______ 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. ^.c^^i r^\\ST\^Property Owner ^''6 "^ <-I Fo '' T ^^ Contractor. Property Address ^ <? C7 ^<> "7 ^ ^^ <^e.^ Authorized Agent__ B ^ ^/ '/^ d i^-^ ^ ^s-^-e-^ \^T ^^ ^Agent's Telephone.7—~" —~TTelephone l^ I -z. ^ cl (^ ( ci <> Y _ Written Authorization Attached: Y or N Accurate Legal Description is requested: J/4 of_1/4 Section "? 2- Township ^/ N. Range ^ W. Town of ^-& Additional Legal Description: T<^^ o -/- -/" ^< A^^-^^£-^ Subdivision ^T^ u ^ (L^V' LCL^Govt. Lot 2- Lot 2- Block Subdivision Lot _ CSM#_ Vol. _ Page _ CSM Doc #. Volume_Page_of Deeds Tax I.D# ^ / D 7 _Acreage / Indicate reasoning for your determination: iJ ^ c[<^^ e.^- So • ( - /Lj o o-^ ^ 4'Vp^? <-?-f ? ^ L^-T^ ^i^^ -^^ </^5^^ T ^. Signature of Certified Soil Tester /- ^0 -^ Date C^:T ZZDO^O Certification # Signature of County Official (Submit a Plot Plan & Fee) Date u/forms/soiltestwaiver(KLK) June 2018^ ^^ ^^y ^j5 S'^ ^/yt > <^<rc./ w^\ /^l ^s, ^ ^ i^ ^ ^^ishm. '.{"^fLMi^^ Ksw y^ v:k. o^r+/0u^r: i^^l D^cr:f+<>n;- T°^K^;,ms:^ \(-l^_ ~< 7iJ ^i ^~'-~ /_-, . _'. • a ^c) I fioi^'n^.''.,;^«4 '^;^ A^^^^ S^32.T^/N R^ W ^^1^72:1^ ^0-/eJ' (^&c.^^^li^^ ^^L^^^o-^'T^i^^^^Y^^ ^^^+ ^-r^^lc^ Bc^ R-i_ Proy'e.r^'/ Ous^&r^ /n. 3kd1 ^ : ^ ^ ft ^e. ^:? »^ ^ &S~^°7 Tfl t-o n <o ^ : B-c / ^ dcct.^ ^'/^Y^t •£ ^ i T^ 1^^i^7 °^~ ^^ci c^ ^i ^ ^c "" ^^/ H(i wo"P Sedrms: 3 '^\ GA<vlli s. 4'i'a } 0- ,' \f; •^ ; •^i 0 ; ^, '.^ f\. -.> ^^ ^ t>:a'z&ToociA/I<'n ^\.<;€.r t.ei^cve.^^T^n^•1^/'U^/VJ f^r^m'y±-^^: •T^k- fA p/cw^€.','^^:h' ^. ^<L. jlj e ^ <... u0,., go wa y\ S Po» n-f- ^ fll . ,4 ( -i"s. <?C Vi -a- 'i-j JLL^ <.y >.;'.. i-K um 0^ »^—J <'., 1^.;--- d v-'i U'CIA-I &(,^ ^wfti..! In-le t'y/fc. i<£"l'lj &i,'c^>.l'.e i t\ p -f ^ I fit. r- i'n c i^£ - H A ,F.^'. i/'"S^^^°- I'C" ftv.'F.S- z -I- 7, 00 ^ /<r< n<,"7«n ^ /H<£,€-"/-^ <^ // Art/ n, £e,4<L(tc^:.s C^'PS.SS'S) A.F.fr. = Afco^e. -^''/'•i&( cj ^<x.c!e. -o-=. uJe.H-r^'T70.^ , ,, "fcf e-F (L.e-^'-^-e-^e. -fi»'J"1- <J-«""^'' <a"^ ^ " B^^R.P^Sle.u/co.of •J 1 7 3 ^ Sck ^o r^c ^/-F i6 ^ d ^ec-^ o^ ^ ^ . (//'AST/»1 £> t-7^S" d/?^ y<c </&ct p'-^€, m<i,+^-«:>.{ ^ H® l/i ^"T^w 1c Cem^<5^~t r'V}Cs. v\ L<-<% /, 1-t S€-c( , ^n u.®. I'(vgR £^); ^m^zfl^2.-'&©i7) £W(,Jn ^: m.EKS.izc^O Pelke'S.ki ^am!>'^ P^,Sox:&-z-z Trc^i /^e< w3- ^-YS'Y^ BAYFIELD COUNTY CHECKLIST FOR CERTIFIED SOIL TESTS Submit the Following (Use Permanent Ink); E3 Check List El Index Page / Title Sheet (Optional) El Original Soil Evaluation Report (Submitted in Deed Holders. Name - not prospective buyers) 12? Original Plot Plan a Cross Section Soil Profile Sheet (optional) D Additional Information (Warranty/Quit Claim Deed) (Optional) Soil Evaluation Report: (Include the following Information) 3\ Parcel Identification Number (must be 23 digit Tax ID#) DO NOT USE 12 digit, they are no longer being used 13 Property Owner's Information (not prospective buyer's name) B Property Location (Accurate Legal Description with Sec/Twp/Range) El Road Name (where driveway is/will be coming off of) IZ1 Ftoodplain Elevation, Flow Rate, Comments and Recommendations d Complete Soil Boring / Pit Information E! Date Soil Evaluation was conducted 13 CST Name, Signature, Number, Address and Phone Number D *Date Stamp* Plot Plan: (Include the following information drawn to dimension or to scale) 0 Bench Mark (Description, Elevation and Location) U Contour Lines (Example = 98.0' ,96.0' ,94.0') El Pioperty Location (Sec/Twp/Range/, Accurate Legal Description) 62 Borings (Locations and Elevations) i..j Percent and Direction of Land Slope 0 Well Location (Including Neighboring Wells, if applicable) 1/1 Location of Wetland Areas, Floodplain and Navigable Waters IZI Buildings, Driveways, and Structures (Location and Descriptions) ^ Location of Property Lines Ef Existing System Location [Zf Address Number and Road Name [3 Current Surface Elevation of Wetlands and Navigable Waters ^ CST, Owner and Property Information North Arrow Fee: S3 Certified Soil Tests - Review & Filing Fee $ 50.00 . u/forms/sanitary/checklist/checklistforcsts