The URL can be used to link to this page

Home My WebLink About63-26SK-aoyy3 ORIGINAL ;E.... 4<., ENTERED , Wisconsin Department of Safety 8 Professional Services 6/17 ,J Page / of , I ,4 Division of lndustryServices �0 =P= SOIL EVALUATION REPORT TEST # 3- � r per. In accordance with SPS 385, Wis. Adm. Code County � Attach complete site plan on paper not less than 8 112 x 11 inches in size. Plan must include, id but not limited to vertical and horizontal reference point (BM), direction and percent slope, I Parcel I.D. 1y7� scale or dimensions, north arrow, and location and distance to nearest road. I '%d x Ye•� Please print all Information. Rev,r Date/ Personal Information you provide may be used for secondary purposes (Privacy Law, s. 15.04(1)(m)). fG I b t Property Owner Property Location 7 /lei Govt. Lot A. ' S J 3 T yV N R O$' E (or) W Property Owner's Matting Address Site Address or CSM and Lot #: S R O'51n K a" fl r 7.33 (3? (12cr ;Z r: L/ ,Qcr&r sNFG grn4es c b J ye e,F F i$ ens-) City, State, Zip I Phone Number ❑ City ❑ village J Town Nearest Road Deua,.,...,...J £V%& g NewConstruction Use: 14 Residentlal/Numberofbedrooms I ❑ Replacement ❑ Public or commercial —Describe: Parent material_D /ae ≥i..( eufl.6 SA General comments and recommendations: 6 C4_& q ,, /W Boring # Code derived designflow rate GPD Flood Plan elevation if applicable ft. rsfe 9 vim' Yy 6'-? sotVc ❑Boring �p ® Pit Ground surface elev.Ze ft Depth to limiting factor/J 0 in. / elev. A. Rnil Annlirafinn Pam 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 G" ?•S Yt i 15 .2 Mt r At -fit !1'w /cevw .7 /. t 9— 1 1.5 ' SL .Z...shfr /r.vfw W ca - to 3 a- ):s A St *s44' ..arP G -w /vF .6 I -c n-i.e' ? rRf S O —S& sit — /4 JUN 16 2 Boring # ❑Boring Bayfield Co. ImPit Ground surface elev .Z fL Plannirtg8jitq TdlgngiAgaacto(20 in./elev .? ft. Cnil Annlirnfinn Ram Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Gr. Sz. sh. Consistence Boundary Roots GPD/Ft2 'Eff#1 'Eff#2 �- l•SYiC L '-'f M r awre �'M, /Gaya ,7 ., .1 - 1 S -K y3 SL tf rp Cry✓ v 6 .b 3 I• z )•SYK 4,7q SIL .. ss ,sR 6a✓ vP .6 !.O `i -/2o xrrtr r/,.fir 4t1 CST Name (Please Print) Signature CST Number Address `/ 770 4.0 y sWe j A U Date Evaluation Conducted I Telephone Number ! -lv (- 9 'Effluent #1 = BOD > 30 5 220 mg/L and TSS > 30 5150 mg/L 'Effluent #2 = BOD, 530 mg/L and TSS 530 mg/L SBD-8330 (R03122) - . Page -2 of ❑ Boring ❑ 3 Boring # ®Pit Ground surface elev./O d' % R. Depth to limiting factor/2O in. / elev. /1 c�1 Soil Application Rate Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPDIFt2 *Eff#1 'ER#2 /r y .,Sr'�� 1 '' 5 2,IL! i" v t �47 7 /Lava" i 2( 274 Y 3 L 2nsAt rF.C G(✓ cdvR . /d -Sr/ yR * .s.tAY vft( &$/ /vft !. D 5W -no r �' S d -S(, ______nit - .7 ,G ❑ ❑ Boring Boring # ❑ Pit Ground surface elev. ft. Depth to limiting factor in. / elev. ft. Soil Application Rate Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/Ft2 Eff#1 'Eff#2 ❑ ❑ Boring Boring # ❑ Pit Ground surface elev. ft. Depth to limiting factor in. / elev. ft. Soil Application Rate Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/Ft2 Eff#1 Eff#2 ECOMM JU 16 Plannin; :. nd 3c.,,,.,-?- c ;cy Effluent #1 = BOD > 30 S 220 mg/L and TSS > 305150 mg/L S% Sr'- dfZ luact4 Effluent #2 = BOD, 530 mg/L and TSS 5 30 mg/L 7,1s'-6$' ( -h'90 30/3 A/% I 9Wn c•^ Debi Mcl So,, 11 Vs -c- No!!r'4kc 01. ()"Am " oad 1. r SYv3 L 1, egtl 84,c/ l d Io Pr4' A ess town ot Ors.0J 5_; TYYM £ o s' w 5r ivy/h V. 11Y3 P 9f' 3'3s ( 34 cr'c1 FL ...?ryes yes Goosed /r e4' *t - 204r) 04r) rayrdit ,Yp'3 bL Pro. well' RECE WED JUN 167026 Bayfield Co. Planning and Zoning Agency `IS3q S Lov jr��ea Q� mows /3m-iod 4"+ rro,a( j14$ 0.TSEfl4) elezr fit 99.F l32. 99.t 133 9q? ?g'ro5r, 9S'3 ys fck+ EL. e yY e •" w/4 KY t jr-it S,4Gtzlzl 7i s-- 6 Pt - i190 to 0 1 N BAYFIELD COUNTY CHECKLIST FOR CERTIFIED SOIL TESTS Submit the Following (Use Permanent Ink): Check List L. .,,dex Page / Title Sheet (Optional) R Driginal Soil Evaluation Report (Submitted in Deed Holders Name — not prospective buyers) 2 -Original Plot Plan ❑ Cross Section Soil Profile Sheet (optional) ❑ Additional Information (Warranty/Quit Claim Deed) (Optional) Soil Evaluation Report: (Include the following Information) I� Parcel Identification Number (must be 23 digit Tax ID#) DO NOT USE 12 digit, they are no longer being used Property Owner's Information not prospective buyer's name) 1operty Location (Accurate Legal Description with Sec/Twp/Range) I?1oad Name (where driveway is/will be coming off of) RECEIVED ❑ Floodplain Elevation, Flow Rate, Comments and Recommendations a'6omplete Soil Boring / Pit Information JUN 16 2026 �te Soil Evaluation was conducted Bayfield Co. Planning and Zoning Agency �ST Name, Signature, Number, Address and Phone Number —Gate Stamp* Plot Plan: (Include the following information drawn to dimension or to scale) Winch Mark (Description, Elevation and Location) Intour Lines (Example = 98.0' /96.0' /94.0') I roperty Location (Sec/Tww/Range/, Accurate Legal Description) Borings (Locations and Elevations) 4 rcent and Direction of Land Slope ® Well Location (Including Neighboring Wells, if applicable) ❑ Location of Wetland Areas, Floodplain and Navigable Waters Buildings, Driveways, and Structures (Location and Descriptions) L�7Location of Property Lines ❑ Existing System Location 2Address Number and Road Name ❑ Current Surface Elevation of Wetlands and Navigable Waters .8'�ST, Owner and Property Information O'North Arrow Fee: D'Certified Soil Tests - Review & Filing Fee $ 50.00 U/forms/sanitary/checklist/checklistforests B TFIELD 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: NELSON, BRADLEY L & DEBRA J SR -00443 11855 HOLLY LAKE RD DRUMMOND, WI 54832 Transaction Number: SR-00443-47EA2 Description Amount Certified Soil Tests - Review & Filing Fee $50.00 Total: $50.00 Payment Amount: $50.00 Reference: 5470 Paid by: A -Z Enterprises, Nor -Pines Plumbing, PO Box 196, Drummond WI 54832 Payment Type: Check Transaction Date: 6/17/2026 Receipt of payment does not guarantee eligibility of permit and is not proof of issuance of a permit.