HomeMy WebLinkAbout49-26p5 3.0-F, 3
Soil Test # _
Bayfield County
Waiver of a Thorough Soil & Site Evaluation
(subject to 15-1 -1 0(d))
TVAN VAN 4 lu s l a certified soil tester determine that in my professional
judg ent 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 & I 1—e .420r
Property Address .5,25- 737/V - ii) &A) Authorized Agent
Contractor
Agent's Telephone,
Telephone 3/- 1- %3 /' 1R7C Written Authorization Attached: Y or N
Accurate Legal Description is requested:
114 of 1/4 Section o / Township ,7 7 N. Rangeel�LW. Town of 15th
Govt.
Lot I Lot Block Subdivision CSM#
Volume Page of Deeds Parcel I.D# Acreage
Additional Legal Description: ( 3
Indicate reasoning for your determination: o )o% is n,n E
ac_C� Lr, aQtuoln l9 - ≤oi I (. MAU(s..s .4es no? nICtf 4 %.
flcla llra W Ibni yn p¢ &ctrt4Ge .
Sfg ature of Certified Soil Tester
Signature o C unty Offt ial
(Ijoltoa(a
Date
Date
//I)6r
Cert fication #
(Submit a Plot Plan & Fee)
RECEIVED ulforms/soiltestwaiver(KLK)
February 2005
MAY 222026
Bayfield Co.
Planning and Z _
oFp�urirtq.,,., SR- 00q lb
Wisconsin Department of Safety & Professional Services
Page 1 of 3
_' Division of Industry Services
SOIL EVALUATION REPORT
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 (8M), direction and percent slope, Parcel I.D.
scale or dimensions, north arrow, and location and distance to nearest road.
.d'C
3732r
Please print all information. R le ed by
15.04(1)(m)).
Date C%
'I(%
Personal information you provide may be used for secondary purposes (Privacy Law, s. l�
Property Owner
Property Location Li
I ❑ El
-Paul Harper
Govt. Lot 1 Y4 v.5 29 T 51
N fj E (or) W
Property Owner's Mailing Address
Site Address orCSM and Lot #:
PO Box 251055
City, State, Zip Phone Number friCity uViOage ux Town Nearest Road
Woodbury, MN 361-331-1875 Bell East Romans Piont Rd
X I New Construction Use: 2 ResidentiaUNumber of bedrooms 2 Code derived deslgnflow rate 300 GPD
Replacement Public or commercial -Describe: Flood Plan elevation if applicable_ _ ft
Parent material Glacial till R�CEiVEI)
General comments and recommendations: Holding Tank MAY 222026
Boring# Poring Bayfield Co.
X
X Pit Ground surface Bleu. ft. Depth to limiting factor Planlev d Zoning Agency
SoilAooli�e I
Horizon
Depth
In.
Dominant Color
Munsell
Redox Description Qu.
Az. Cont. Color
Texture
Structure
Cr. Sz. Sh.
Consistence
Boundary
Roots
GPD/Ft
*Eff#1
*Eff#2
1
0-6
7.5yr3/2
-
L
2msbk
mfr
cs
3m
.6
.8
2
6-10
7.5yr3\4
LF 7.5yr 5/6 Spotf
Cl
2sbk
mfi
cw
2f
.4
.6
3
10-20
5yr3/4
Cl
3sbk
mefi
Cs
.2
.3
Boring#
2
Boring
X Pit Ground surface elev.
ft. Depth to limiting factor in./elev. ff.
I SailSail Aoo
Horizon
Depth
In.
Dominant Color
Munsell
Redox Description Qu.
Az. Cont. Color
Texture
Structure
Gr. Sz. Sh.
Consistence
Boundary
Roots
GPO! Ft
*Eff#1
*Eff#2
1
0-4
7.5yr3/2
-
L
2msbk
mfr
cs
3m
.6
.8
2
4-8
7.5yr3\4
LF 7.5yr 5/6 Spot
CI
2sbk
mfi
cw
2f
.4
.6
3
8-18
5yr3/4
Cl
3sbk
mefi
cs
.2
.3
CST Name (Please Print)
Signature
CST Number
Ryan Van Ornum
^-- —
11011
Address
Date Evaluation Conducted
Telephone Number
65907 Jolma Rd Marengo, WI
5-15-2026
(715) 413-0074
*Effluent#1=BOD> 30 s 220mg/L and TSS>30 s150mg/L *Effluent#2=BOD,s 30mg/L and TSS s 30mg/L
SBD-8330 (R03/22)
J3AYFIELD 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:
HARPER, PAUL F SR -00416
PO BOX 251055
WOODBURY, MN 55125 Transaction Number:
SR -00416-47893
Description
Certified Soil Tests - Review & Filing Fee
Amount
$50.00
Total: $50.00
Payment Amount: $50.00
Reference: 104
Paid by: Northwoods Soil & Site, 659 Jolma Rd, Marengo
Payment Type: Check
Transaction Date: 6/10/2026
Receipt of payment does not guarantee eligibility of
permit and is not proof of issuance of a permit.