HomeMy WebLinkAbout138-26SR-OoSOq
Wisconsin Departmentof Safety and Professional Services Page / of
,c Division of Industry Services
SOIL EVALUATION REPO$OIL TEST #13 8 o? &
In accordance with SPS 385, Wiis. Adm. Code County Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, `� {� fl 'ffu
u C ��
but not limited to: vertical and horizontal reference point (BM), direction and percent slope, Parcel I.D.
scale or dimensions, north arrow, and location and distance to nearest road. 37 S 96
Please print all Information. RGcei� Viewed by/,i a nDates/ry
Personal information you provide may be used for secondary ourooses (Privacy Law. s. 15.04(11(m11 7.rn 1111 ii (I& & rir II I I /,mss
' 'ii""r "" Property Location - U l�1
/)ti1 i q \I 1 G. -iv Z( A- 7 I Qtly t C. )rt Govt. Lot •SQ % N b Y. S 04 T S) N R E (or) W
Property Owner's Mailing Address Site Address or CSM and Lot M.
3600 Lr-rrc' S1 t3 T�'l'c R. . 7"36 00 LI TLt_ s4+✓a [Z4T _
City State i Zip Code i Phone Number ❑ City ❑ Village Town I Nearest Road
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❑ New Construction Use: lk� Residential/Numberofbedrooms Code derived designiow rate So GPD
❑ Replacement ❑ Public or commercial —Describe: Flood Plan elevation if applicable ft. ENTERED
Parent material C, L4El Ac-- TLL q IN a6
General comments and recommendations: Its ) b 0 O
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1❑ Boring# Boring
Pit
Ground surface elev0 B 73ft. Depth to limiting factor 1 Zin. / elev l•48ft.
Soil Application Rate
Horizon
Depth
In.
Dominant Color
Munsell
Redox Description
Qu. Az. Cont. Color
Texture
Structure
Gr. Sz. Sh.
Consistence
Boundary
Roots
GPDIFt2
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-Eff#2
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Boring #
❑Boring
p1Pit Ground surface elev.OS 5.3ft1C . Depth to limiting factorI5in. I elev 7,ZBft.
Soil Aoolication Rate
Horizon
Depth
In.
Dominant Color
Mansell
Redox Description
Qu. Az. Cont. Color
Texture
Structure
Cr. Sz. Sh.
Consistence
Boundary
Roots
GPDIFt2
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Eff#2
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CST Name (Please Print)
Signature
I,gpot3
CST Number Bayfield Co.
Planning and Zoning Agen
/Z 9l—
Address
Date Evaluation Conducted
Telephone Number
90 Cub CA3 ' wy
715-]S -3355
i
" Effluent #1 = BOD > 30£ 220 mg/L and TSS > 30 5 150 mg/L ' Effluent #2 = BOO, 5 30 mglL and TSS 5 30 mglL
SBD-8330 (R04/21)
❑❑ Boring Fqi
'3 Boring # Pit Ground surface elev.S • S.ft.
Page &4 of
Depth to limiting factor_in. I elev 25%t.
I SoilAooli
Horizon
Depth
In.
Dominant Color
Munsell
Redox Description
Qu. Az. Cont. Color
Texture
Structure
Gr. Sz. Sh.
Consistence
Boundary
Roots
GPD/Ft'
Eff#1
Eff#2
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❑ Boring #
❑ Boring
❑ Pit Ground surface elev. ft. Depth to limiting factor in. / elev.ft.
e.m e....r..�r:,... o.».,
Horizon
Depth
In.
Dominant Color
Munsell
Redox Description
Qu. Az. Cont. Color
Texture
Structure
Gr. Sz. Sh.
Consistence
Boundary
Roots
GPD/Ft'
'Eff#1
•Eff#2
❑ Boring #
❑ Boring
❑ Pit Ground surface elev. ft. Depth to limiting factor in. / elev.ft.
Horizon
Depth
In.
Dominant Color
Munsell
Redox Description
Qu. Az. Cont. Color
Texture
Structure
Gr. Sz. Sh.
Consistence
Boundary
Roots
GPD/Ft'
'Eff#1
'Eff#2
Effluent #1 = BOD > 30 s 220 mglL and TSS > 30 5150 mg/L * Effluent #2 = BOD, 5 30 mg/L and TSS 5 30 mg/L
1 ECEiVED
SEP 11 2026
Bayfield Co.
planning and ZorJn,- A rjC fl
CHECK BOX AS APPLICABLE
CHECK BOX AS APPLICABLE.
O SOIL EVALUATION
Scale: 40'
❑ SYSTEM PAGE 2 OF
0
SITE MAP
40 60
80
PLOT PLAN
PROJECT NAME:
, DESIGN FLOW: NS0 GPD
rzl [S° 1 c hi f�/ ov r
(10 n gad)
10
Attach design flow calculations for commercial plans.
PROJECT ADDRESS: 436 0c L IT-ItL Sd N Z)
tom -(
Pipe Material / ASTM Standard (Tables 384.30-3 & 384.30-5)
BM Symbol: BM Elevation: DO .0
GT
Sanitary Sewer. /
BM Description: �� W tZL yTznN
Force Main:
Gradient(%) a
Sl Slope Gradient
ted dient 4 Well Symbol (if applicable): Q
Indicate north by
drawing an annoy
on the approP rite line
IMPORTANT:
Show ground elevation contours at suitable intervals.
OV M E'.. J t_ g'— : C_Oti-t R- '-nc cIov Cfl
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SEP 112026
Planning era aunt"Te-.._.
F I E L D 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:
TRIBOVICH, PAUL L & VICTORIA
93600 LITTLE SAND BAY RD
BAYFIELD, WI 54814
Description
Certified Soil Tests - Review & Filing Fee
Submission Number:
SR -00509
Transaction Number:
SR -00509-562A9
Amount
$50.00
Total: $50.00
Payment Amount: $50.00
Reference: 15176
Paid by: Andry Rasmussen & Sons, PO Box 66, Cable WI 54821
Payment Type: Check
Transaction Date: 9/25/2026
Receipt of payment does not guarantee eligibility of
permit and is not proof of issuance of a permit.