HomeMy WebLinkAbout72-24;rl?-0?S i5/^/
Bayfield County
Soil Test #
Waiver of a Thorough Soil & Site Evaluation
(subject to 15-1-10(d))
I B^<-? ^ ^LAK<L^l^ _ ^ certified soil tester determine that in my^ofesSiot^l
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.
Property Owner ^>^^^ H^LIC^ Contractor
Property Address 8103^ L<^Wfc^ R^ Authorized Agent_
ti-fc?>r^ k^ ^8^ __________ Agent's Telephone_
Telephone '7/^- W - S-0^ _ Written Authorization Attached: Y or N
Accurate Legal Description is requested:
J[E_1/4 of SJA/ 1/4 Section V Township ^^ N. Range ^ W. Town of C-LO^R>
Govt
Lot_Lot Block_Subdivision_CSM#
Volume_Page_of Deeds Parcel I.D# //' ^ J? _______________ Acreage.
Additional Legal Description:.
Indicate reasoning for your determination:inatinn. ^^^7^, ^. ^-S/%^A.
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Signature of Ceftified Soil Tester
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Date
^w//^
Certification #^
Signature of County Official
(Submit a Ptqt Plan & Fee)
Date
u/forms/soiltestwaiver(KLK)
February 2005
72-24
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