HomeMy WebLinkAbout18-25<»R-- oc^z.7,
Soil Test #
Bayfield County
Waiver of a Thorough Soil & Site Evaluation^ f ^ y l;,\
(subject to 15-1 -10(d)) i, j||
il!| APR t /20Z6 B
I EDWARD JWROBLEWSKI _ g CertJfled soil tester determine that in my professional
judgment the following site (see below) is unsuitable for any treatment component ottier than hol'dirig
tanks. Due to soil & site conditions, a thorough soil and site evaluation is not needed to make such a
determination.
Property Owner SAM N & ELIZABETH A KUCHINKA _ C ontractor EDIS MECHAN ICAI- LLC
Property Address 79400 HOWELL RD _ Authorized Agent EDWARD j WROBLEWSKI
WASHBURN.WI 54891 _ Aflent'S Telephone "15-209-4055
Telephone 512-432-2254 _ Written Authorization Attached: Y or IN]
Accurate Legal Description is requested:
Nw 1/4 of SE 1/4 Section 16 Township 49 N. Range °4 W. Town of BAYVIEW
Additional Legal Description: LOT 2 CSM #2241 iNvi3p7i IN DOC 2022^595730
Govt. Lot _ Lot _ Block Subdivision
Lot _ CSM#_ Vol. _ Page _ CSM Doc #
Volume_Page_of Deeds Tax J.D# 3881S _Acreage !54
Indicate reasoning for your determination: CLAY SOILS AND EvtDENCE OF BEDROCK
Signature of Certified Soil Tester
/2.//(./2^
Date
SP-72000013
MSL_^). / 1 ''77') Certification #
Signature ^>f County Official
(Submit a Plot Plan & Fee)'Z;7|Zb
Date
u/forms/soiltestwaiver(KLK).00 ^|^l^5> V<<LH June'2018
^-OOZll
Bayfield County
Soil Test #
EDWARD J WROBLEWSKI
Waiver of a Thorough Soil & Site Evaluation^ u ?i ^ 11 ||/ ip
(subject to 15-1-10(d)) ! j ' ^ ' '
APK 1 7 2026
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.
Owner SAM N & ELIZABETH A KUCHINKA
Property Address 7940° HOWELL RD
WASHBURN, Wl 54891
Telephone.612-432-2254
Contractor ED'S MECHANICAL LLC
Authorized Agent EDWARD J WROBLEWSKI
Agent's Telephone.715-209-4055
Written Authorization Attached: Y or |Nj
Accurate Legal Description is requested:
Nw 1/4 of SE 1/4 section 16 Township 49 N. Range °4 W. Town of BAYVIEW
Additional Legal Description:.LOT 2 CSM #2241 IN V. 13 P.71 IN DOC 2022R-595730
Govt. Lot
Lot_CSM#
Volume
Lot Block Subdivision
Vol Page
Page_
CSMDoc#
of Deeds Tax I. D# 38818 .Acreage.1.54
Indicate reasoning for your determination: CLAY so"-s AND EVIDENCE OF BEDROCK
Signature of Certified Soil Tester
i-^/f^/^
Date
SP-72000013
Signature of County Official
Date
Certification #
(Submit a Plot Plan & Fee)
u/forms/soiltestwaiver(KLK)
June 2018
EDWARD J WROBLEWSKI, CST ,!(SP-72000013
SOIL TEST PLOT PLAN
SAM N & ELIZABETH A KUCHINKA
79400 HOWELL RD
LOT 2 CSM # 2241 IN V.13 P.71 IN
DOC 2022R-595730 (LOCATED IN
GOVT LOTS 2 & 3) AS DEED DOC
2022R-596605
S16T49NR04W
TOWN OF BAYVIEW, Wl
SCALE 1"= 50-
II ^ ^ !Ri
,- n)Z5 N
16 26 3i) 46 SHEET 3 OF 3
BAYFIELD COUNTYCHECKLIST FOR CERTIFIED SOIL TESTS t ^
'.^'
Submit the Following (Use Permanent Ink):
^ Check List
sgljndex Page / Title Sheet (Optional)
Original Soil Evaluation Report (Submitted in Deed Holders Name - not prospective buyers)
Original Plot Plan
OTross Section Soil Profile Sheet (optional)
D Additional Information (Warranty/Quit Claim Deed) (Optional)
Soil Evaluation Report: (Include the following Information)
Parcel Identification Number (must be 23 digit Tax ID#} DO NOT USE 12 digit, they are no longer being used
Property Owner's Information (not prospective buyer's name)
Property Location (Accurate Legal Description with Sec/Twp/Range)
Road Name (where driveway is/will be coming off of)
^ Floodplain Elevation, Flow Rate, Comments and Recommendations
D Complete Soil Boring / Pit Information
A] Date Soil Evaluation was conducted
^ CST Name, Signature, Number, Address and Phone Number
^*Date Stamp*
Plot Plan: (Include the following information drawn to dimension or to scale)
D Bench Mark (Description, Elevation and Location)
D Contour Lines (Example = 98.0796.0',94.0')
Property Location (Sec/Twp/Range/, Accurate Legal Description)
(jZJ Borings (Locations and Elevations)
D Percent and Direction of Land Slope
Well Location (Including Neighboring Wells, if applicable)
Location of Wetland Areas, Floodplain and Navigable Waters
Buildings, Driveways, and Structures (Location and Descriptions)
Location of Property Lines
Existing System Location
Address Number and Road Name
Current Surface Elevation of Wetlands and Navigable Waters
.CST, Owner and Property Information
.North Arrow
Fee:
.Certified Soil Tests - Review & Filing Fee $ 50.00 U/forms/sanitary/checklist/checkllstforcsts