HomeMy WebLinkAbout154-25SR-oo37H
Soil Test # /C
Bayfield County
Waiver of a Thorough Soil & Site Evaluation ENTERED
(subject to 15-1-10(d)) I___
EDWARD J WROBLEWSKI 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.'-_)
Property Owner MATTHEW J & JODY HIPSHER
Contractor ED'S MECHANICAL LLC
Property Address 21705 SISKIWIT LAKE RD Authorized Age
CORNUCOPIA, WI 54827
Telephone 715-209-7322
Accurate Legal Description is requested:
NW 1/4 of NE 1/4
Additional Legal Descri
EDWARD J WROBLEWSKI
Agent's Telephone 715-209-4055
Written Authorization Attached: Y or NO
Section 21 Township 50 N. Range 06 W. Town
NW NE 277 IN DOC 2023R-600188
Govt. Lot Lot Block Subdivision
Lot CSM# Vol. Page CSM Doc #
Volume Page of Deeds Tax I.D# 7483
Indicate reasoning for your determination: CLAY SOILS
RECEIVED
DEC 19 2025
Bayfield Co.
Planning and Zoning AgencY
�3� 3
Signs re of County Official
a/z/n/ s
Date
ge 40.00
Signature of Certified Soil Tester
It It7(2o25
Date
SP -72000013
Certification #
(Submit a Plot Plan & Fee)
u/forms/so i lte stwa iver(K LK)
June 2018
EDWARD J. WROBLEWSKI, CST #SP -72000013
SOIL TEST PLOT PLAN
MATT AAND JODY HIPSHER
21705 SISKIWIT LAKE RD
CORNUCOPIA, WI 54827
NW NE 277 IN DOC 2023R-600188
S21 T50N R06W
TOWN OF BELL, WI
SCALE 1" = 50'
EXISTING
SHED
'100 TO WEST LOT LINE
>100' TO SOUTH LOT LINE
SISKI WIT LAKE RD
BARN
I
0 10 20 30 40 SOFT
SHEET 2 OF 2
BAYFIELD COUNTY
CHECKLIST FOR CERTIFIED SOIL TESTS
Submit the Following (Use Permanent Ink):
y "Check List
❑ Index Page / Title Sheet (Optional)
Original Soil Evaluation Report (Submitted in Deed Holders Name — not prospective:buyg�`9 U
Original Plot Plan DEC 19 2025
❑ Cross Section Soil Profile Sheet (optional)
yfieW CO
❑ Additional Information (Warranty/Quit Claim Deed) (Optional) punning and Zoning
A9enc/
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)
O Floodplain Elevation, Flow Rate, Comments and Recommendations
❑ Complete Soil Boring / Pit Information
XDate Soil Evaluation was conducted
ICST Name, Signature, Number, Address and Phone Number
*Date Stamp*
Plot Plan: (Include the following information drawn to dimension or to scale)
Bench Mark (Description, Elevation and Location)
Contour Lines (Example = 98.0' /96.0' /94.0')
Property Location (Sec/Twp/Range/, Accurate Legal Description)
] Borings (Locations and Elevations)
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:
I Certified Soil Tests - Review & Filing Fee $ 50.00 U/forms/sanitary/checklist/checklistforests
P. -A -YFIELD 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:
HIPSHER, MATTHEW J & JODY SR -00374
22450 SISKIWIT LAKE RD
CORNUCOPIA, WI 54827 Transaction Number:
SR -00374-3A289
Description Amount
Certified Soil Tests - Review & Filing Fee $50.00
Total: $50.00
Payment Amount: $50.00
Reference: 2861
Paid by: Ed's Mechanical, 1491 County Hwy C, Washburn WI 54891
Payment Type: Check
Transaction Date: 12/19/2025
Receipt of payment does not guarantee eligibility of
permit and is not proof of issuance of a permit.