HomeMy WebLinkAbout22-26RECEIVED yii�eFD
t .x nii i
S�-oa396 APR 172026
/ Wisconsin Department of Safety & Professional Servic paYRab Co. Page 1 of 3
l%! 1 =` fanning and Zoning Agency —
�Division of Industry Services
�$ [ SOIL EVALUATION REPORT SOIL TEST #
In accordance with SPS 385, Wis. Adm. Code County
Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, Bayfield
but not 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. 39845
Please print all Information.
rm Date//
Personal intonation you provide may be used for secondary purposes (Privacy Law, s. 15.04(1)(m)). 37/315i
Property Owner Property Location ' U Q✓
Micheal R. & Kimberly M. Sherry Govt. Lot 3 V. ¼S 7 T 48 N R 4 E (or) W
Property Owner's Mailing Address SlteAddress or CSM and Lot #:
3313 Golf Course Rd 74500 Lake Shore Dr. Washburn, WI 54891
City, State, Zip Phone Number City Village I Town Nearest Road
Ashland ,WI 54855 / A� Barksd a Lake Shore Dr.
New Construction Use: % Residential/Number of bedrooms 3 Code derived designflow rate 450 GPD
% Replacement Public or commercial -Describe: Flood Plan elevation If applicable ft.
and recommendations: Holding tank do to soil and limited space on site withn setbacks and boundaries.
1 BoringN BBoring
x Pit Ground surface elev. ft. Depth to limiting factor in./elev. ft.
I SOIL Application Rate
-a(
Horizon
Depth
In.
Dominant Color
Munsell
Redox Description Qu.
Az. Cont. Color
Texture
Structure
Gr. Sz. Sh.
Consistence
Boundary
Roots
GPD/Ft
*Eff#1
*Eft#2
1
0-4
5yr4/2
_
sit
lmsbk
mvfr
CW
3f
.4
.6
2
4-11
5yr3/4
f[f5yr5/6
sic[
2abk
mfr
cw
2f
.2
.3
3
11-30
5yr4/4
C
3 �aok
mfi
.3
Boring 0 BBoring
2 Plt Ground surface elev. ft. Depth to limiting factor in./Bleu. ft.
Soil Soil Anolication Rate
Horizon
Depth
In.
Dominant Color
Munsell
Redox Description Qu.
Az. Cont. Color
Texture
Structure
Gr. Si. Sh.
Consistence
Boundary
Roots
GPD/Ft
*Eft#1
•Eff#2
CST Name (Please Print)
Signature
CST Number
Ryan Van Ornum
L/"--i;?
11011
Address
Date Evaluation Conducted
Telephone Number
65907 Jotma Rd Marengo, WI
4/13/2026
(715) 413-0074
* Effluent #1= BOD ' 30 s 220 mg/L and TSS '305150 mg/L *Effluent #2= SOD, 530 mg/L and TSS s 30mg/L
SBD-8330 (R03/22)
RECEIVED
APR 17 2026
Bayfleld Co,
planning and Zoning Agency
Soil Test #
Bayfield County
Waiver of a Thorough Soil & Site Evaluation RECF T
(subject to 15-1 -1 0(d))
APR
l L/4ib V111 w wu'^^ a certified soil tester determine thaW1J9tQfessional
judgment the following site (see below) is unsuitable for any treatment componen of er thYfiblding
tanks. Due to soil & site conditions, a thorough soil and site evaluation is not needed to make such a
determination.
Property Owner 111e&•e4l R. c ki.A b'1 M. 5 4eNa y Contractor
Property Address 7gcoo 4,51kr 5 4'vvt" Or. Authorized Agent
Ljay�bu/^n, WZ' Sy451 / Agent's Telephone
Telephone (7/5) ?o 39 yy Written Authorization Attached: Y or N
Accurate Legal Description is requested:
114 of 1/4 Section -2 —Township y ? N. RangeW. Town of
Govt.
Lot 3 Lot Block Subdivision CSM#
Volume Page of Deeds Parcel I.D# Acreage
Additional Legal Description:
Indicate reasoning for your determination: Du.n Po to i / n ti22i Iietir S
7
Signature of County Official
/AC
Date
Stature of Certified Soil Tester
&/// 3/
Date
/101/
Certification #
(Submit a Plot Plan & Fee)
u/forms/soiltestwaiver(KLK)
February 2005
$-^YFIELD Bayfield County
Planning & Zoning Department
117E 5th Street
P.O. Box 58
Washburn, WI 54891
Phone: 715-373-6138
Fax: 715-373-0114
Property Owner:
SHERRY, MICHAEL R & KIMBERLY M
3113 GOLF COURSE RD
ASHLAND, WI 54806
Description
Certified Soil Tests - Review & Filing Fee
Submission Number:
SR -00396
Transaction Number:
SR -00396-44205
Amount
$50.00
Total: $50.00
Payment Amount: $50.00
Reference: 101
Paid by: Ryan Van Ornum, 65907 Jolma Rd, Marengo WI 54855
Payment Type: Check
Transaction Date: 4/17/2026
Receipt of payment does not guarantee eligibility of
permit and is not proof of issuance of a permit.