The URL can be used to link to this page

Home My WebLink About121-26SR-oo4g3 Wisconsin Department of Safety& Professional Services SOIL TEST # ,ai -2. (, Paget of 2.. Division of Industry Services SOIL EVALUATION REPORT „�„,�„�•v 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, but not limited to vertical and horizontal reference point (BM), direction and percent slope, Pitef scale or dimensions, north arrow, and location and distance to nearest road. TAX Please print all information. R ie Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04(1)(m)). Property Owner I Property Location ❑ Tmo t- iek Govt. LotNW %SE %SZ T4 E(pr)w Property Owner's Mailing Address I Site Address or CSM and Lot #: [I] City, State, Zip Phone Number I U City U Village IX1 Town Nearest Road i. .1.-..r_ AA .I!"i—G I 1 .71n. CQ/l-7.n 1') 'f_ _ D`..a.e AI t D • T 17.. 1g New Construction Use: ❑ Residential/ Number of bedrooms ❑ Replacement 11 ❑ Public or commercial — Describe: Parentmaterial 5O.ntly Yi 11 General comments and recommendations: I Boring # RECEIderiveddesignflowrate y$_D GPD Flood Plan elevation if applicable ft. AUG 18 2026 ERIEREU . and ❑ Boring IX Pit Ground surface elev1I(_ft, Depth to limiting factor7in. / elev.g_ft. Soil Application 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 'Eft#2 1 - o - is Zcr m cc 3 .7 I. L -2 7 y/ - I a5 3n .7 3 -36 &VR.Hft.f- rice O ciA 2 1. — s l 1 .7 1. Boring # ❑Boring -� > [, Pit Ground surface elev. tC-.3 ft. Depth to limiting factor 90 in. / elev.OQ. 8 ft. Soil Application 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 U 012 — 1S Z� rr r4 -c- cc 3 1,6 7- -at 7.cYPJ113 — 5irlc Imsbk. -cV C 3 -3d, S — 34-v l c5 3 1. - 90 S 'i — 9rS— 1, 6 CSTT Name (Please Print) Signatur J CST Number [ � t ✓. u G Address St l S C.'t'Y w`( S Date Evaluation Conducted Telephone Number r n :de✓ c' ^ Z ZI -3 1- O $5 • Effluent #1 = BOD > 30 5 220 mg/L and TSS > 30 5150 mg/L ` Effluent #2 = BOD, 5 30 mg/L and TSS 5 30 mg/L SBD-8330 (R03/22) Page Z of 2, aBoring # ❑ Boring Pit Ground surface elev. 1q 7.3 ft. Depth to limiting factor$in. / elev.I(__ft. Soil Application 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 O7 t(7'iR/ I — 1 S G 2 -2 7f1f3 — 3r1c wS1&� ev,$ro .7 1, 3 - y r' cva.S 05 l C$ 2-C .7 1, 4 -- 8 7, s y — 4 ❑ 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. Sz. 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. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/Ft2 *Eff#1 *Eff#2 * Effluent #1 = BOD > 30 ≤ 220 mg/L and TSS > 30 ≤ 150 mg/L * Effluent #2 = BOD, ≤ 30 mglL and TSS ≤ 30 mg/L ------------------------------- \\\ Combined Soil Evaluation Plot Plan -System Plot Plan 0 50 100 ft Component Manual Design References: , .. N ti\\\ In -Ground Soil Absorption for POWTS Version 2.1 13' 9 4 „ G7 (' ) � - i ApproxProperty Line 1�1 2 \ - 3a I iii \\\\ o Soil Test Pits: rn 1 - Elevation - 99.1' 2 2 - Elevation - 97.3' \\ 3 - Elevation - 97.3' I Tax ID: 38604 \\ o Benchmark - Screw in White Pine Owner: TIMOTHY C SIEH \\ Elevation - 100' 3 Trenches Quick 4 Plus Standard Chambers Site Address:66430 NORTH POINT \ I DR, IRON RIVER, WI 54847 l s Existing Well Permanently Abandoned 4% Slope Legal Description: S21 T47N R08W \ by Wayne Holly Well Drilling 2 N 800' IN NW SE IN 2017R-571079 m 1 LESS V.257 P.10 & LESS PAR IN \ Tank - Wieser WLP1 000 -MR O ° DOC 2021 R-590953 482 \ Filter - PolyLoc PL -525 All piping shall conform / Proposed 3 an ! Bedroom Home sPs Table 384.30-3 ,,, SPS Table 384.30-5 Existing 3 Bedroom Home Soil Evaluated By: Tony Polkoski - 11068 -ST Plumber: Allan Polkoski - PMRS 220090 Pike Lake Elevation 56.8' BAYFIELD COUNTY CHECKLIST FOR CERTIFIED SOIL TESTS Submit the Following (Use Permanent Ink): X Check List ($ Index Page / Title Sheet (Optional) Z Original Soil Evaluation Report (Submitted in Deed Holders Name — not prospective buyers) D( Original Plot Plan ❑ Cross Section Soil Profile Sheet (optional) ❑ Additional Information (Warranty/Quit Claim Deed) (Optional) Soil Evaluation Report: (Include the following Information) R Tax Identification Number (must be 5 digitTax ID#) DO NOT USE 12 digit, they are no longer being used ffi Property Owner's Information (not prospective buyer's name) IEd Property Location (Accurate Legal Description with Sec/Twp/Range) RECEIVED lCK Road Name (where driveway is/will be coming off of) ❑ Floodplain Elevation, Flow Rate, Comments and Recommendations AUG 18 2026 D( Complete Soil Boring / Pit Information Bayfield Co. Planning and Zoning Agency X Date Soil Evaluation was conducted X CST Name, Signature, Number, Address and Phone Number ($ *Date Stamp* Plot Plan: (Include the following information drawn to dimension or to scale) X Bench Mark (Description, Elevation and Location) a Contour Lines (Example = 98.0' /96.0' /94.0') D( Property Location (Sec/Twp/Range/, Accurate Legal Description) * Borings (Locations and Elevations) ($ Percent and Direction of Land Slope t$ Well Location (Including Neighboring Wells, if applicable) VZ Location of Wetland Areas, Floodplain and Navigable Waters I$ Buildings, Driveways, and Structures (Location and Descriptions) R Location of Property Lines Existing System Location X Address Number and Road Name IA Current Surface Elevation of Wetlands and Navigable Waters CK CST, Owner and Property Information X North Arrow Fee: N Certified Soil Tests - Review & Filing Fee $ 50.00 Wforms/sanitary/checMist/checMistforests P Y F I E LD 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: SIEH, TIMOTHY C SR -00493 1346 Arrowhead Rd No 203 Duluth, MN 55811 Transaction Number: SR-00493-4DOC0 Description Amount Certified Soil Tests - Review & Filing Fee $50.00 Total: $50.00 Payment Amount: $50.00 Reference: 6345 Paid by: Polkoski Plumbing, PO Box 522, Iron River WI 54847 Payment Type: Check Transaction Date: 8/31/2026 Receipt of payment does not guarantee eligibility of permit and is not proof of issuance of a permit.