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Home My WebLink About107-26RECEIVED AUG 0 4 2026 Wisconsin Department of Safety& Professional Services Page 1 of__3 Division of Industry Services plaa Bayfield Co. SIB- Ob'-ISd- SOIL EVALUATION REPdOIoingamzonirwANY#iLIL TEST #io?-z✓r In accordance with SPS 385, Wis. Adm. Code County Bayfield Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, scale or dimensions, north avow, and location and distance to nearest road. 04-024-2.47-08-22-2 00-323-17000 but not limited to vertical and horizontal reference point (BM), direction and percent slope, Parcel I.D. Please print all Information. Reviewed by Date Personal information you provide may be used for secondary purposes (Privacy Law, S. 15.04(l)(m)). 111 //O Property Owner Property Location ❑ ❑ Derek E. & Emily M. Johnson Govt. Lot 'A v. S 22 T 47 N R 08 E (or) Property Owners Mailing Address Site Address or CSM and Lot #: 66545 Hart Lake Rd 66535 Hart Lake Rd City, State, Zip I Phone Number ❑ City ❑ Village ® Town I Nearest Road Iron River, WI 54847 f Iron River I Hart Lake Rd ❑New Construction Use: Residential! Numberof bedrooms 3 Code derived designflow rate 450 GPD ® Replacement ❑ Public or commercial —Describe: Flood Plan elevation if applicable N/A ft. Parent material Outwash Sands (Rubicon-Sayner complex) General comments and recommendations: ❑ Boring 1 Bonn # ® Pit Ground surface elev. 104.4 ft. Depth to limiting factor 96 in. / elev. 96_4 ft. Soil Application Rate Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Cr. Sz. Sh. Consistence Boundary Roots GPO/Ft' •Eff#1 -Eff#2 1 0-3 10YR 2/2 — s Osg ml as 2vf 0.7 1.6 2 3-18 1 OYR 4/6 — s 0sg ml gw 3m/3f/3vf 0.7 1.6 3 18-41 10YR 5/4 — s 0sg ml CW 2m/1f 0.7 1.6 4 41-96 10YR 6/4 — s Osg ml — — 0.7 1.6 Horizon 4 has ban s of lam llae 2❑ Boring # ❑Boring ®Pit Ground surface elev.101.1 ft. Depth to limiting factor 96 in. / elev. 93.1 ft. Soil Soil Anolication Rate Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Cr. Sz. Sh. Consistence Boundary Roots GPD/Ft2 Eff#1 *Eff#2 1 0-3 1 OYR 2/2 — Is 0sg ml aw 2vf 0.7 1.6 2 3-14 7.5YR 4/4 — Is 0sg ml gw lm/1f 0.7 1.6 3 14-36 1 OYR 4/4 — s 0sg ml gw 2camvrr 0.7 1.6 4 36-52 1 OYR 4/6 — S 0sg ml gw 1 m 0.7 1.6 5 52-96 10YR6/4 — s Osg ml — 1f 0.7 1.6 Horizon 5 has bans of lam Ilae CST Name (Please Print) Signatur CST Number Keith Wiley 654921 Address Date Eluation Conducted Telephone Number 11623 E Larson Dr. Lake Nebagamon, WI 54849 7/19/2026 218-451-2611 Effluent #1 = BOO > 30 5 220 mg/L and TSS > 30 s 150 mgfL * Effluent #2 = BOO, 5 30 mg/L and TSS s 30 mgfL SBD-8330 (R03/22) Paget of 3 3❑ Boring # ❑ Boring Pit Ground surface elev. 101.1 ft, Depth to limiting factor 96 in. / elev. 93_1 ft. Soil Application Rate Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Cr. Sz. Sh. Consistence Boundary Roots GPO/F1' *Eff#1 'Eff#2 1 0-7 10YR 2/2 — S Osg ml as lm/2f/lvf 0.7 1.6 2 7-18 7.5YR 4/4 — s 0sg ml Cw 1�f1nv1f 0.7 1.6 3 18-42 10YR 5/4 — s 0sg ml gw 1m/1f 0.7 1.6 4 42-96 10YR 6/4 — S Osg ml — — 0.7 1.6 ❑ 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/Ft' •Eft#1 'Eff#2 ❑ Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. I 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/Ft2 •Eff#1 •Eff#2 Effluent #1 = BOD > 30 5 220 mg/L and TSS > 30 5150 mg/L RECEIVED AUG 04 2026 Bayfie1d Co. planning and Zoning Agency ' Effluent #2 = BOO, 5 30 mg/L and TSS s 30 mg/L Johnson (3 bedroom) Soil Report Plot Plan North 105' 103' 101' 99, Septic tank & drainfield to be abandoned per 5P5383.33 Scale 1:40 17.4% O 0Well 3 bedroom house K Bench Mark = Duplex nail w/orange disc in 14" DBH pine tree Elev = 100.0' NOTES: Derek E. & Emily M. Johnson 66545 Hart Lake Rd PLAT OF ELLENWOOD LOT 17 IN DOC 2021R-587599 S22 T47N RO8W Town of Iron River 04-024-2-47-08-22-2 00-323-17000 3.120 acres l0 W N C o W U &' w Co - Property lines not shown > 50' from tested area - Lake Millicent elev z 60' CST 119900002 -SP Page 3 of 3 BAYFIELD COUNTY Derek & Emily Johnson CHECKLIST FOR CERTIFIED SOIL TESTS Submit the Following (Use Permanent Ink): l9'Check List ❑ Index Page / Title Sheet (Optional) 7 Original Soil Evaluation Report (Submitted in Deed Holders Name — not prospective buyers) M' Original Plot Plan ❑ Cross Section Soil Profile Sheet (optional) ❑ Additional Information (Warranty/Quit Claim Deed) (Optional) Soil Evaluation Report: (Include the following Information) l' Parcel Identification Number (must be 23 digit Tax ID#) DO NOT USE 12 digit, they are no longer being used E 'Property Owner's Information not prospective buyer's name) ID' Property Location (Accurate Legal Description with Sec/Twp/Range) 62' Road Name (where driveway is/will be coming off of) ID' Floodplain Elevation, Flow Rate, Comments and Recommendations ID' Complete Soil Boring / Pit Information 7 Date Soil Evaluation was conducted ID'CST Name, Signature, Number, Address and Phone Number 9 *Date Stamp* Plot Plan: (Include the following information drawn to dimension or to scale) @'Bench Mark (Description, Elevation and Location) I�'Contour Lines (Example = 98.0' /96.0' /94.0') @'Property Location (Sec/Twp/Range/, Accurate Legal Description) El Borings (Locations and Elevations) ED' Percent and Direction of Land Slope E' Well Location (Including Neighboring Wells, if applicable) IX Location of Wetland Areas, Floodplain and Navigable Waters ID' Buildings, Driveways, and Structures (Location and Descriptions) @'Location of Property Lines 6d' Existing System Location ID' Address Number and Road Name 7 Current Surface Elevation of Wetlands and Navigable Waters IQ'CST, Owner and Property Information ED' North Arrow RECEIVED AUG 0 4 2026 Bayfield Co. Planning and Zoning A9anc' Fee: ID' Certified Soil Tests - Review & Filing Fee $ 50.00 U/forms/sanitary/checklist/checklistforests B 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: Submission Number: JOHNSON, DEREK E & EMILY M SR -00482 66535 HART LAKE RD IRON RIVER, WI 54847 Transaction Number: SR-00482-4B6D5 Description Certified Soil Tests - Review & Filing Fee Amount $50.00 Total: $50.00 Payment Amount: $50.00 Reference: 1111 Paid by: Coyote Septic Works LLC, 11623 E Larson Dr, Lk Nebagamon WI 54849 Payment Type: Check Transaction Date: 8/11/2026 Receipt of payment does not guarantee eligibility of permit and is not proof of issuance of a permit.