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Home My WebLink About46-26SZ_poha} Soil Test# Bayfield County b S� Waiver of a Thorough Soil & Site Evaluation RECEIVED (subject to 15-1-10(d)) !� MAY 282026 t 1Jim Vk4rt, a certified soil tester determine that in my professional judgment the following site (see below) is unsuitable for any treatment component other than h'ottirl� tanks. Due to soil & site conditions, a thorough s nd site evaluation is not needed to make such'ae determination. ENTERED SIQ Property Owner cw .e_ , Vernon Contractor Vhstne Canstr,.i+on Inc Property Address ,�S gl0 Cozy Corner EA Authorized Agent7n O�ks/n, /S&LJ 'hull cv806 Agent's Telephone 7/S-IJ..2 9S,?f Telephone -7117-X09_QZ 9g Written Authorization Attachedor N Accurate Legal Description is requested: S r 1/4 of S h_� 1/4 Section/9_Township 1/8 N. Range OS W. Town of 8orlCsolole Additional Legal Description: Govt. Lot Lot Block Subdivision Lot CSM# Vol. Page CSM Doc # aO/9R -57703x_ Volume Page of Deeds Tax I.D# t5 3'I q q (o Acreage 1O'Vi Indicate reasoning for your determination: 57k Poe5 /JOT st f 4 fy Signature Certified Soil Tester c /?o/)e Date /�>3ass Certification # Signature of Co my Official Date (Submit a Plot Plan & Fee) u/forms/soiftestwa iver(KLK) June 2018 RECEIVED S�-ooga-a- 1 2 =...�E, �F� 'z• Wisconsin Department of Safetyand Professional Services MAY 28 2026 Page of Division of IndustryServices fs'sr ' SOIL EVALUATION REPORTPlanningea d zng Agency �a"'crarv•1yv 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, Bayf eld County 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. 04-002-2-48-05-19-4 04-000- 0000 Please print all information. Reviewed by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04(1)(m)). Property Owner Property Location ❑ ❑✓ Daniel+Jenna Vernon Govt. Lot SE V. SE v. S 19 T 48 N R 05 E (or) W Property Owner's Mailing Address Site Address or CSM and Lot #: 25810 Cozy Comer Rd 25810 Cozy Corner Rd City State Zip Code Phone Number ❑ City ❑ Village It Town Nearest Road Ashland WI 54806 715209252i Barksdale Cozy Corner New Construction Use: Residential/Numberof bedrooms I Bath Code derived designftow rate 150 GPD Replacement ❑ Public or commercial —Describe: Flood Plan elevation if applicable R. Parent material Clavev Till General comments and recommendations: Site does not meet A+4. Holding tank recommended LIiI Boring# ❑Boring Pit Ground surface elev. - R. Depth to limiting factor in. / elev. ft. Soil Aoolication Rate Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/FP Eff#1 Efr#2 A 0-5 5YR3/1 SIL 2 -pr -c mvfr as if 0.6 0.8 B 5-9 5YR 5/3 f -1-f 2.5YR 5/8 SL 2-sbk-c mfr as - 0.6 1.0 C 9-18 2.5YR 4/6 C 3-cpr-vc dl, - - 0.2 0.3 2 Boring # ❑Boring ItPit Ground surface elev. ft. Depth to limiting factor in. / elev. ft. Soil Annlication Rate Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/Ft' •Eff#1 •Eff#2 CST Name (Please Print) I Signature CST Number Tim Dykstra Z-I? 1213855 Address I Date Evaluation Conducted I Telephone Number 10620 Eagle Lake Rd Iron River WI 5-20-26 1715-209-5748 • Effluent #1 = BOD > 30 5 220 mg/L and TSS > 30 5150 mg/L ' Effluent #2 = BOD, s 30 mg/L and TSS 530 mg/L SBD-8330 (R04/21) Paget oft J Boring # ❑ Boring 0 Pit Ground surface elev. ft. Depth to limiting factor In. / elev. ft. Soil Application Rate Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/Ft2 Eff#1 Etf#2 ❑ Boring # ❑ Poring ❑ Pit Ground surface elev. ft. Depth to limiting factor In. / elev. ft. Soil Application Rate Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/Ft' *Eff#1 'Eff#2 MAY 2820'6 Planning a d Zoning gency ❑ Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. / elev.ft. Soil Application Rate Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/Ft2 Eft#1 'Eff#2 ' Effluent #1 = BOD > 30 5 220 mg/L and TSS > 305150 mg/L' Effluent #2 = BOD, S 30 mg/L and TSS S30 mgfL parcel Vernon a.SBIo Cozy cocnr a A-st+ wr 5yeo6 Twn oP /3cvrLcscLk Tx TD 369gr wx 13ay At, 5o* Tee1 ..� I Ubao C� li L4..t Rd fo 12vtr wr sv8y7 CSY# la\39' S S/a %ca —z 42rr Rt CEENED MAY 282026 Bayfield Co. Planning and Zoning Agency NER RD J =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: VERNON, DANIEL G & JENNA K 25810 COZY CORNER RD ASHLAND, WI 54806 Description Certified Soil Tests - Review & Filing Fee Submission Number: SR -00422 Transaction Number: SR-00422-46B8B Amount $50.00 Total: $50.00 Payment Amount: $50.00 Reference: 3370 Paid by: Timothy Dykstra, 10620 Eagle Lake Rd, Iron River WI 54847 Payment Type: Check Transaction Date: 5/29/ 2026 Receipt of payment does not guarantee eligibility of permit and is not proof of issuance of a permit.