HomeMy WebLinkAbout43-24MAY n 3 '/'DZ4
Bayfield County
Soil Test #
Waiver of a Thorough Soil & Site Evaluation
(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.
Property Owner JOANNA WEISHAR
Property Address 26235 STAR ROUTE
BAYFIELD, Wl 54814
Telephone.262-622-3284
Contractor EDIS MECHANICAL LLC
Authorized Agent.EDWARD J WROBLEWSKI
Agent's Telephone.715-209-4055
Written Authorization Attached: Y or IN
Accurate Legal Description is requested:
Nw 1/4 of NW 1/4 Section 20 Township 50 N. Range °5 W. Town of BAYFIELD
Additional Legal Description: £1/201/2 NWNwiNv.9i3p.26n INDOC2024R-601589
Govt. Lot Lot Block
Lot CSM# Vol.
_Subdivision
Page
Volume _Page_
CSM Doc #
of Deeds Tax I.D# 5273
Indicate reasoning for your determination:HIGH GROUND WATER & CLAY SOILS
.Acreage.10.0
Signature of County Official^ /^/^
Date
^
Signature of Certified Soil Tester
^M^x
Date
SP-72000013
Certification #
(Submit a Plot Plan & Fee)
u/forms/soiltestwaiver(KLK)
June 2018
#43-24
EDWARD J WROBLEWSKI, CST )?SP-72000013
SOIL TEST PLOT PLAN
JOANNA WEISHAR
26235 STAR ROUTE RD
BAYFIELD, Wl
E1/2 E1/2 NW NW IN V.913 P.2 611
INDOC-2023R-601589
S20 T50N R05W
TOWN OF BAYFIELD, Wl
SCALE 1"= 50'
N
STAR ROUTE RD
>100'TO WEST LOT LINE
EXISTING
HOUSE
>100'TO SOUTH LOT LINE
:t—^—^_20 30 40 50FT SHEET 2 OF 2
^i((h BAYFIELD COUNTY
CHECKLIST FOR CERTIFIED SOIL TESTS
:w ;•
^' •'/Submit the Following (U se Permanent In k): /
'Check List
..--a-index Page / Title Sheet (Optional)
Q'lOriginal Soil Evaluation Report (Submitted in Deed Holders Name - not prospective buyers)
"Original Plot Plan
_JJ-Cross Section Soil Profile Sheet (optional)
.. -ETAdditional 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
E-^roperty Owner's Information (not prospective buyer's name)
Location (Accurate Legal Description with Sec/Twp/Range)
S^Koad Name (where driveway is/will be coming off of)
•O-FToodplain Elevation, Flow Rate, Comments and Recommendations
D Complete Soil Boring / Pit Information
Ttate Soil Evaluation was conducted
;ST Name, Signature, Number, Address and Phone Number
D *Date Stamp*
Plot Plan: (Include the following information drawn to dimension or to scale)
Mark (Description, Elevation and Location)
..-B-Contour Lines (Example = 98.0' ,96.0' ,94.0')
Q^roperty Location (Sec/Twp/Range/, Accurate Legal Description)
Sorings (Locations and Elevations)
,,.0-Percent and Direction of Land Slope
--0"Well Location (Including Neighboring Wells, if applicable)
-EKocation of Wetland Areas, Floodplain and Navigable Waters
Suildings, Driveways, and Structures (Location and Descriptions)
'Location of Property Lines
.---rTExisting System Location
'Address Number and Road Name
--E^urrent Surface Elevation of Wetlands and Navigable Waters
'CST, Owner and Property Information
Jorth Arrow
Fee:
Certified Soil Tests - Review & Filing Fee $ 50.00 U/forms/sanitary/checklist/checklistforcsts