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Home My WebLink About145-25• 1e��tv�® SOIL TEST #/4'S-5 .2 RWisconsin Department of Safety& Professional Services Pa_u: I of p2 Di ` nP o h 1-K rvices S R- O o3&3 • �oV SP$ SOIL EVALUATION REPORT Bayfield Co. Agency In accordance with SPS 385, Wis. Adm. Code County Attach complete site plan an paper not less than 8 1/2 x 11 inches in size. Plan must include, �'' td.— but nut limited to vertical and horizontal reference point (BM), direction and percent slope, Parcel I.D. scale or dimensions, north arrow, and location and distance to nearest road. 0 q t'! Please print all information. Ravi e y Llinte Personal information you provide may be used for secondary purposes (Privacy Law. s. 15.04(1)(m)). �I7 /r 3/ I��QQ_ /�(/7/.2l J Property Owner —_- rty�p {' y�1 itpuNT`� RZ'• '� E14eV♦Lk7('pQ LCeua-+o-Zi mmernn0.v� Ir�r� Riot e�r.1(ti�(,KWI Property Owner's Mailing Address Site Address or CSM and Lot #: 8S`'oo Sarsev Ave. S Han Lakes R __ City, State, Zip Phone Number ❑ City ❑ Village Town Nearest Road C.t as w.t,tfls 1 4It SI4S19 tea Rwei $4ctrr Lcke, : New Construction Use: Residential/Numberof bedrooms Code derived designflowrate d20:;PD U Replacement /� ❑ Public or commercial — qescribe: Flood Plan elevation if applicable ft. Parent material Drat W O SIn SC%?d $ General comments and recommendations: WBoring # ❑ Boring a K Pit Ground surface elev9butt. Depth to limiting fact?" [Qin. / eleS$19. Suit Applicalior Rafe Horizon Depth In. Dominant Color Munsell Redox Description Go. Az. Cont, Color Texture Structure Gr. Sz. Sit. Consistence Boundary Roots GP_D/Fh ' Eff#1 '_Eff#2 .` IV 1 _ • I_I•�r- 3..__ -3! — l 1e 6 ci !3 — rn ^ -- 1�6 Boring # Boring XP -t Ground surface elevft. Depth to limiting Fact) 1QQin. ! elr8.$,tj$I Soil Aanlicahon Rate Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPDIFF ' 'Efftl I I Effrr2 L__ o-& 10 — Is Ks6k ml CtL3ct .-7 l-6 R-`i — Ic ii -1.19 s m - jvc. ,- wG - :111I CST NaName (Please riot Signature �/ CST Number < Q �h.--[.__,_-. Address cur C. -v( 1':W N Date Evaluation Conducted Telephone Number Zfen:ye✓r S ZIPI-sfiI'70S_S' Effluent #1 = BOD > 30 5 220 mg/L and TSS > 30 5 150 mg/L ' Effluent #2 = SOD. 5 30 mg/L and TSS 5 30 mg/L SBU-8330 IR03/"221 RECEIVED NOV 14 2025 Boring Eonng n �] Pit Ground surface ele16t4!(ft. Bayfetd Co. Planning and Zoning Agency Page of Depth to limiting facto t in. / eleBjt ft. Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Cr. Si, Sh. Consistence Boundary Roots 0-6 — Js Is6x. t%t c.vJ 3.o fit y 1 c. ^ 1cS 4 S — ^ j Boring N Soil Application Rate GPD/FI• 'Efl#1 ' Eff#2 .1 I. ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor •n.I elev. ___fl. Soil Application Rate Horizon Depth In, Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Cr, Si. Sh. Consistence Boundary Roots GPD/FP •Effk1 Eff#2 Boring ft ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. / elev. h. Soil APPlicanon Kate Horizon Depth In, Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Cr. Si. Sh. Consistence Boundary i Roots GPD/FP •Effttl 'Effd2 Effluent it1 = BOD >30 5 220 reg/L and TSS >30S150 mg/L ' Effluent ft2 = SOD. S 30 mg/L and TSS S30 ring/I Soil Evaluation Site Map - System Plot Plan In Ground Soil Absorption for POWTS Component Manual V_2.1 Map Coordinate Reference System: Site Owner: Kevin Zimmerman NAD83(2011) I WISCRS Bayfield (ftUS) EPSG:7590 Site Address: 66680 Hart Lake Rd, Iron River, WI 54847 Legal Description: Lot Three (3), Bayfield County Plat of Ellenwood, Town of Iron River, Bayfield County, Wisconsin PIN: 04-024-2-47-08-22-2 00-323-03000 a.. 0 50 100 ft ----------------------------------------- 1 N .�E� 'D �� Sanitary Permit Dimentions List (applicable).:: Nov 14 Z025 � Proposed 2 bedrom home: 30' x 40' - ' Building to lot lines: ≥145' Bayfiefj co. Building to road centerline: 192' Planning aid Zoning Agency Septic tank to closest lot line: 134' Septic tank to building: 15' Drain field to closest lot line: 90' Drain field to building: 25' Tank- Wieser WLP750-MR Filter- PolyLoc PL -525 Effluent Filter BM- • S�Cp £B3 Q iSB1 ' pf cI IJ 00• �° 9d i o O r m i oil r r r r r i i r r r r r r r 4" Pipe Material I ASTM Standard; (Tables 384 30-3 & 384.30-5) ; No Well on Property Sanitary Sewer ASTM F789 ! O No Wetlands, Floodplains or Navigable Waters fr / ; Approximate Property Line � r - - BM - Screw in Poplar Tree - Elevation 100.00' r r A SBI - Elevation 96.50 r A SB2 - Elevation 96.81 C r A SB3 - Elevation 96.64 r r CST Name & License #: Ton Polkoski 11068 - ST r , +f CST Signature: -- a r r i i Plumber Name & License #: Allan Polkoski PMRS 220090 Plumber Signature: G.... i i r r --------------------------------------------------------------------------------------------------- ' , ECE1VEU NOV 14 2025 BAYFIELD COUNTY CHECKLIST FOR CERTIFIED SOIL TESTS Bayfiy'f r°. Sulpn tstPM'Following (Use Permanent Ink): I� Check List Il Index Page / Title Sheet (Optional) I)t Original Soil Evaluation Report (Submitted in Deed Holders Name — not prospective buyers) Original Plot Plan L Cross Section Soil Profile Sheet (optional) LI Additional Information (Warranty/Quit Claim Deed) (Optional) Soil Evaluation Report: (Include the following Information) qQ Parcel Identification Number (must be 23 digit Tax ID#) DO NOT USE 12 digit, they are no longer being used d9 Property Owner's Information (not prospective buyer's name) Property Location (Accurate Legal Description with Sec/Twp/Range) 10 Road Name (where driveway is/will be coming off of) fl Floodplain Elevation, Flow Rate, Comments and Recommendations io Complete Soil Boring / Pit Information rp Date Soil Evaluation was conducted )C CST Name, Signature, Number, Address and Phone Number r *Date Stamp' Plot Plan: (Include the following information drawn to dimension or to scale) )I Bench Mark (Description, Elevation and Location) F)0 Contour Lines (Example = 98.0' /96.0/94.0') x Property Location (Sec/Twp/Range/, Accurate Legal Description) K Borings (Locations and Elevations) Y5 Percent and Direction of Land Slope Well Location (Including Neighboring Wells, if applicable) IX Location of Wetland Areas, Floodplain and Navigable Waters K(' Buildings, Driveways, and Structures (Location and Descriptions) Location of Property Lines t ' Existing System Location •-' N/A 'Address Number and Road Name ❑ Current Surface Elevation of Wetlands and Navigable Waters — N/Itn lX CST, Owner and Property Information A North Arrow Fee: f�V Certified Soil Tests - Review & Filing Fee $ 50.00 u/forms/san,vary/checknsr/checkilstforesrs 13 -YIELD Bayfield County Planning & Zoning Department 117 E 5th Street P.O. Box 58 Washburn, WI 54891 Phone: 715-373-6138 Fax: 715-373-0114 Property Owner: Submission Number: ZIMMERMAN, KEVIN K SR -00363 8500 JENSEN AVE S COTTAGE GROVE, MN 55016 Transaction Number: SR -00363-3881E Description Amount Certified Soil Tests - Review & Filing Fee $50.00 Total: $50.00 Payment Amount: $50.00 Reference: 6274 Paid by: Polkoski Plumbing, PO Box 522, Iron River WI 54847 Payment Type: Check Transaction Date: 11/17/2025 Receipt of payment does not guarantee eligibility of permit and is not proof of issuance of a permit.