HomeMy WebLinkAbout72-26Soil Test #
Bayfield County
5 Ps Waiver of a Thorough Soil & Site Evaluation
(subject to 15-1 -1 0(d))
Pc'( koski a certified soil tester determine that in my arofessional
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.
RECEIVED
Property Owner Do.,na.. L Fct.(Tp,r Contractor JUN 222026
N_ ABayfieldCo.
Property Address Twt T D - 38 115- Authorized Agent Planning and ZoningAgency
Agent's Telephone
Telephone 7 1 S— @(-i — O I O S Written Authorization Attached: Y or N
Accurate Legal Description is requested:
NE 1/4 of S 1/4 Section _Township_Lf N. Range9_W. Town of OO LU
Additional Legal Description: [— 'I2 Sk) IA) Doc &OI99-S79t!o y7
Govt. Lot Lot Block Subdivision
Lot CSM# Vol. Page CSM Doc #
Volume Page of Deeds Tax I.D# 38115-- Acreage S
Indicate reasoning for your determination: ReAox: vnc..r laic'eec,tvte.t car& preScvcr-
W Li 'tyt chte c "rite e4 h pr i 2cv, S Ps 3 S S 3 O L?) C 6)1
Signature of tertified Soil Tester
-S-z6
Date
/(dam -S7
Sign ture o County Sticial
Date
II061b-ST
Certification #
(Submit a Plot Plan & Fee)
u/forms/soi Itestwa iver(KLK)
June 2018
Soil Evaluation Plot Plan - System Plot Plan 0 50 100 ft
Component Manual Design References: I I I I I I N
--------------------------------- ----r
Holding Tank Version 2.1 ; I - /
/2
Owner: Dana L Falter
Site Address: No Fire Number
Shared driveway with 2515
Rankinson Rd, Brule, WI 54820
Tax ID: 38115
Legal Description: NE SW
S29-T48N-R09W
E 1/2 SW IN DOC 2019R-579647
Town of Oulu, Bayfield County, WI
o Soil Test Pits
Approx. Property Line
® Benchmark
Screw in Birch tree
Elevation - 100'
RECEIVED
JUN 227975
Bayfield Co.
Planning and Zoning Agency
Wieser
A
C)
W o
2
Pipe Material:-�.e6
ASTM Standard
(Tables 384.30-3 &
384.30-5)
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No existing wells or existing POWTS on Property
Plumber: Allan Polkoski - PMRS 220090
Soil Evaluated By nn Polk ski - 11068 -ST
B-=YFIELD Bayfield County
Planning & Zoning Department
117 E 5a' Street
P.O. Box 58
Washburn, WI 54891
Phone: 715-373-6138
Fax: 715-373-0114
Property Owner:
FALTER, DANA L
2515 RANKINSON RD
BRULE, WI 54820
Description
Certified Soil Tests - Review & Filing Fee
Submission Number:
SR -00448
Transaction Number:
SR-00448-48FB1
Amount
$50.00
Total: $50.00
Payment Amount: $50.00
Reference: 6323
Paid by: Polkoski Plumbing, PO Box 522, Iron River WI 54847
Payment Type: Check
Transaction Date: 6/30/2026
Receipt of payment does not guarantee eligibility of
permit and is not proof of issuance of a permit.