HomeMy WebLinkAbout105-24Bayfield County
Soil Test #
Waiver of a Thorough Soil & Site Evaluation
(subject to 15-1-10(d))
I B<^c^ ^^^^fl^A/^ ______ a certified soil tester determine that in my professional
judgment the following site (see below) is unsuitable for any treatment component ott
tanks. Due to soil & site conditions, a thorough soil and site evaluation is not needed to make such a
determination.
Property Owner ^°^^ I^H^ZA/ _ Contractor
Property Address ^^S~°S' ^OL.^ ^. Authorized Agent.
.J^^M^^^^^-J^-^E^ _ Agent's Telephone.
Telephone_/f/^" 29c^-'/^^/ _ Written Authorization Attached: Y or N
Accurate Legal Description is requested:
_KS£_1/4 of <IE 1/4 Section -?G Township ^? N. Range ^ W. Town of_^_Si^_
Govt.
Lot Lot Block Subdivision_____ _ CSM#
Volume_Page_of Deeds Parcel I.D# /^'S'/oi- ______________ Acreage S"'^
Additional Legal Description: /lnd PA(? JAf <^ IVT
Indicate reasoning for your determination: (\iA^/ Sxr-t, /f HO^'Z-CW /S'5-?
%//?^ /" ^ 5g-/(^^^f^- S^/^(£/t-/^^^,
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Signature of Certified Soil Tester
7/8]^'_
Date
7as^s
/sr^-:5s-2—~,Certification #
z9.'^-^..'--'"'Signature of County Official
(Subinif a Plot Plan & Fee)
Date
u/forms/soiltestwaiver(KLK)
February 2005
105-24
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