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Home My WebLink About77-26SR-oo9S1 Wisconsin Department of Safety& Professional Services Page__I of Division of Industry Services cn' crl�8'3- SOIL EVALUATION f fPLIkTTEST # 77 2(„ ,•�p,�,,. In accordance with SPS 385, Wis. Adm. Code Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but not limited to vertical and horizontal reference point (BM), direction and percent slope, scale or dimensions, north arrow, and location and distance to nearest road. County .D. TA X Please print all Information. Re iewed b Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04(1)(m)). rinilui ii Property Owner Property Location ❑ 0. Rmovdt ` K Govt. Lot I '% %S 2' 197 N R 9 E (or) PropertyOwner's Mailing Address I Site Address or CSM arld Lo #: .S�,n wrtne�6II Pet. SZ%O Wrh Q/J Ed— J ✓D t I�cJCvLf%1S� Date lis''1O7,c �6 State, Zip I Phone Number ❑ New Construction Use: ® Residential/Numberof bedrooms ® Replacement ❑ Public or commercial — Describe: Parent material SO,1A dy 71 1 General comments and recommendations: © Boring # City U Village L19 Town - I Nearest Road ❑Boring pp Pit Ground surface elevr�y. r g,_& ft. Code derived designflow rate 3 CO GPD Flood Plan elevation if applicable ft. Depth to limiting factor ala in./ elev. 1 I_I ft. REC?Ivpn I Soil AoolicationRate Horizon Depth In. Dominant Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary JUL O 1 Roots p GPD/Ft2 `Eff#1 "Eff#2 1 -8 iOyf1i — Is Icir nn -Fr •- Ir6 2 —S nl 2nd Zoni n 1. (O - - S 1 - 1 Boring # 2 - ❑ Boring QQ/ ®Pit Ground surface elev. ft. Depth to limiting factor q6in. / elev. l 1.7 ft. Soil Aoolication Rate Horizon Depth In. Dominant Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/Ft' *Eff#1 *Eff#2 0-9 IV R3/2 - ( I 1r Ml q� 3 1,6 Z -pg S 2y/ — S Os,11S 3cc •-] t6 -9C,SYrcHfI, — S Osj — I -c .-7 1.6 CST Name (Please Print) Tov� I KoS Signature // f4�. / CST Number o c..•�- o Address Jr 11 Jr LGVVN-"H B ..K; er ZS`$ Date Evaluation Conducted -28-26 Telephone Number 7'S -3i g -9g68 Effluent #1 = BOD > 30 5 220 mg/L and TSS > 30 5150 mg/L . Effluent #2 = BOD, 5 30 mg/L and TSS 5 30 mg/L SBD-8330 (R03122) Page Z of 2. 3 Boring # ❑ Boring [ Pit Ground surface elev.4_ft. Depth to limiting factor 7 in. / elevRI.5, ft. Horizon Depth In. Dominant Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/Ft2 *Eff#1 *Eff#2 In 31 I( my a • `7 1. 3 - S wti - I D Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. / elev. ft. I Soil Aonlication Rate Horizon Depth In. Dominant Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/Ft2 *Eff#1 *Eff#2 I Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. / elev. ft. I Soil Aoolication Rate Horizon Depth In. Dominant Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/Ft2 *Eff#1 *Eff#2 * Effluent #1 = BOD > 30 5 220 mg/L and TSS > 30 5150 mg/L * Effluent #2 = BOD, 5 30 mg/L and TSS 5 30 mg/L Combined Soil Evaluation Plot Plan - System Plot Plan In -Ground Soil Absorption for POWTS Version 2.1 Owner: Raymond Levine JR Site Address: 5270 Windall Rd Iron River, WI 54847 Tax ID: 18720 Legal Description: A parcel of land in Government Lot One (1), Section Twenty-six (26), Township Forty-seven (47) North, Range Nine (9) West, Town of Hughes, Bayfield County, Wisconsin, more particularly described as follows: To locate the point of beginning, commence at the point where the East line of said Government Lot 1 intersects the mean high water mark of Ahmeek Lake; thence South, along said East line, 700 feet; thence West, 20 feet, to the point of beginning; thence from said point of beginning, by metes and bounds: continue West, 125 feet; thence North, parallel to said East line of Government Lot 1, 700 feet, more or less, to the mean high water mark of Ahmeek Lake; thence East, along said mean high water mark, 125 feet, more or less, to a point which is 20 feet West of the East line of Government Lot 1; thence South, parallel to the East line of Government Lot 1, 700 feet, more or less, to the point of beginning. ELI Approx Property Line o Soil Test Pits: 1 - Elevation - 99.6' 2 - Elevation - 99.7' 3 - Elevation - 99.6' Benchmark - Screw in Oak Tree Elevation 100' S Existing Well Plumber: Allan Polkoski - PMRS 220090 Soil Evaluated By: Tony Polkoski - 11068 -ST K1w 6a Ahmeek Lake Elevation 56.4' q-------------- Existing 1 I I Concrete I I Tank/Pumpl Chamber Existing 2 Bedroom E? Home I xistin Iarage N tC\aa\\i�ati Tank -Wieser WLP700/300-N I p Filter - PolyLoc ,u 0 Oo' 2 Trenches • Quick 4 Plu! 3 Standard o Chambers 7% Slope Existing Drainfield - System abandonment per SPS 383.33 prior to new system installation. 0 50 100 111111 �J All piping shall conform to SPS Table 384.30-3 and SPS Table 384.30-5 RECEIVED JUL 012026 Sayfield Co. I and Zoning Agency Page 2 of 4 BAYFIELD COUNTY CHECKLIST FOR CERTIFIED SOIL TESTS Submit the Following (Use Permanent Ink): X Check List IZ Index Page / Title Sheet (Optional) Z Original Soil Evaluation Report (Submitted in Deed Holders Name — not prospective buyers) ID( Original Plot Plan ❑ Cross Section Soil Profile Sheet (optional) ❑ Additional Information (Warranty/Quit Claim Deed) (Optional) Soil Evaluation Report: (Include the following Information) IR Tax Identification Number (must be 5 digit Tax ID#) DO NOT USE 12 digit, they are no longer being used X Property Owner's Information (not prospective buyer's name) [ Property Location (Accurate Legal Description with Sec/Twp/Range) ($ Road Name (where driveway is/will be coming off of) ❑ Floodplain Elevation, Flow Rate, Comments and Recommendations X Complete Soil Boring / Pit Information X Date Soil Evaluation was conducted X CST Name, Signature, Number, Address and Phone Number CK *Date Stamp* Plot Plan: (Include the following information drawn to dimension or to scale) X Bench Mark (Description, Elevation and Location) X Contour Lines (Example = 98.0' /96.0' /94.0') D( Property Location (Sec/Twp/Range/, Accurate Legal Description) X Borings (Locations and Elevations) CK Percent and Direction of Land Slope i Well Location (Including Neighboring Wells, if applicable) X Location of Wetland Areas, Floodplain and Navigable Waters X Buildings, Driveways, and Structures (Location and Descriptions) R Location of Property Lines X Existing System Location l Address Number and Road Name Uf Current Surface Elevation of Wetlands and Navigable Waters X CST, Owner and Property Information X North Arrow R CLVIVpt) JUL 0120in Plannin Bavfiela + g ano Zoning „yeri.y Fee: 14 Certified Soil Tests - Review & Filing Fee $ 50.00 U/forms/sanitary/checklist/checklistforests B-ATFIELD Property Owner: LEVINE,CHRISTINE S PO BOX 613 ASHLAND, WI 54806 LEVINE, RAYMOND A JR PO BOX 613 ASHLAND, WI 54806 Bayfield County Planning & Zoning Department 117 E 5th Street P.O. Box 58 Washburn, WI 54891 Phone: 715-373-6138 Fax: 715-373-0114 Submission Number: yte.I1111811 Transaction Number: SR -00451-49A39 Description Amount Certified Soil Tests - Review & Filing Fee $50.00 Total: $50.00 Payment Amount: $50.00 Reference: 6330 Paid by: Polkoski Plumbing, PO Box 522, Iron River WI 54847 Payment Type: Check Transaction Date: 7/9/2026 Receipt of payment does not guarantee eligibility of permit and is not proof of issuance of a permit.