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026-939-12-5214-CST-2022-065
� � � ■� �: ���� - � `��.�RTAI(•,,y�s �,�, ��F m.t.!e'�e,��� � Wisconsin Department of Safety and Professional Services a Page of � ��; � t Division of Industry Services �_� `�sP=• "j SOIL EVALUATION REPORT � 'z��'`"�r,�o��t�'�� In accordance with SPS 385,Wis.Adm. Code SAWYE R 1 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, Parcel I.D. U scale or dimensions,north arrow,and Iocation and distance to nearest road. Q Z(o _ q.3R — �Z- " �Z- � 7 � Please print all information. Revie d by Date � Personal information you provide may be used for secondary purposes(Privacy Law,s. 15.04(1)(m)). � � s1.3/I�.2 Property Owner Property Location ❑ X� � l�e►� (�{., l ls���� R e,� . 1 r�S�"' Govt. Lot Z v. �i s I 2. T 39 N R a 9 E(or) V� Property Owner's Mailing Address Site Address or CSM and Lot#: , � ►43�{ �ako�i A.ve L� �.� Lo-4- q co x Z3o �c �oo City State Zip Code Phone Number ❑City ❑ Village �Town Nearest Road Cross� W� Sybd3 � � S�►� LQk 6 2 rJ (.Jh:-� Ln � NewConstruction Use:�a Residential/Numberofbedrooms�_ Code derived designflowrate b0a GPD �Replacement ❑ Public or commercial-Descri� FI if applicable +-1 Z-ft. Parent material_� <<�. (��l-�t�1 4S � a�j C. ��.Q General comments and recommendations: � � ,� Sp� 5 S S t►,� e�. Tr l � e 9Z. Tr Z Lo� q ( ❑Boring u � � Boring#sp J�� �Pit Ground surface elev. qs•�. Depth to limiting factor << ` in./elev$5•1 ft. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/Ft2 In. Munsell Qu.Az.Cont.Color Gr.Sz.Sh. 'Eff#1 *Eff#2 l p-� 7.S ,, 3Z — s( z� r � F� �.,� I�F .6 �. o � b_ z�v �, � 3 — s z�,s6k << << t�f-� . L c. d 3 �.L ,c[ �< 4 y — r o —s �, � �v� .7 c. � (-� 3 - ��°o a..� � Borin9# M,c - L.0� ❑Boring '�1 / �b r/ / �it Ground surface elev. 31 S ft. Depth to limiting factor in./elev.$s�7� Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/Ft2 in. Munsell Qu.Az.Cont.Color Gr.Sz.Sh. "Eff#1 'Eff#2 I =1 .S r 3�z -- S 1 w� r a-L�F,� w I��' , !� �. a z -2.8 �� � 3 — sl Z� SbI� y << ���� .� l-o zg_�s '' � y � r5 G — s vtn. l .� (vf� .�I l.� � B�_�i �� s .� 5 �� t i _� .� �`7 l.� csT rvame MERTON MAKI si9nat�re �� ���` CST Number 224901 Address 10869N SMITH COURT Date Evaluation Conducted P �715) 634-8719 Tele hone Number HAYWARD, WI 54843 S-ZD Z� _ ZZ *Effluent#1 =BOD>30 s 220 mg/L and TSS>30 5150 mg/L 'Effluent#2=BOD,<_30 mg/L and TSS 5 30 mg/L SBD-8330(R04/21) Page of � �Boring cj c.�.� �D�. SS, �ft. � goring# �o r�11 �'Pit Ground surface elev. ft. Depth to limiting factor in./elev. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/FtZ In. Munsell Qu.Az.Cont.Color Gr.Sz.Sh. •Eff#� •Eff#2 � (�- � `1.5� 3 Z `' �- S( 2. � �t�r c.J l v E . G 1.C� z g_ z �. � q - s � z►�s 6l� �. �, ���,,,� .� l.o 3 z Y- 1 '� �► � - � 5 0 - s w� �� �v�� .-1 r• �O 5_ Io� << '� 3 - ,< <, =-� � • l. (p ❑ Boring# ❑Boring ❑Pit Ground surface elev. ft. Depth to limiting factor in./elev. ft. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/Ft2 In. Munsell Qu.Az.Cont.Color Gr.Sz.Sh. •Eff#1 *Eff#2 �3� k ISb � = 6 — so' � - S � r �� BS ' — 4 � �( -c L � T�- �..Z �f--- =. R�' c� � b S-t- ZSo ❑ Boring# ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in./elev. ft. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/Ft2 In. Munsell Qu.Az.Cont.Color Gr.Sz.Sh. `Eff#1 `Eff#2 � ' a N.Pr ►til U �` G� G�. i� �� J-�-J✓' 'Effluent#1 =BOD>30<-220 mg/L and TSS>30<_150 mg/L 'Effluent#2=BOD,<_30 mg/L and TSS<_30 mg/L � � �� V � S A�� � �ISSUE O PERMIT MAY 31 2022 SAWYER COUNTY Zqd�IVG ADMiNISTRA710N owhe�• ��.I . El�e►-� U. 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R �'.� � � .. . 7. �Y `r/ 1.'�� 5.;. �G� '.t �����Ti �� ' � '¢r +qt ��' ;� .jl ,�� r. : � �'� a� a�.�,��'�' ��� � + � . y' . . , � �, k� . -. i ;S y :}�. p � � S . �d � ."AE� ..�� �I� ,�' 2�x.:�.`�r z. � ,� . �;. r. �'. u�?'_ .r�i, ��,�'. ��t t^ ��" � - u3""',m,r •`�w.k �.� t�;:� a.,..�x.+��''�a,.: �;i. +i Re.al �State Sawyer County Property Property Status• Current Listing ' Today's Date: 5/19/2022 Created On: 2/6/2007 7:55:47 AM Description Updated: l2/27/2012 Ownership Updated: l0/22/2013 Tax ID: 28228 ELLEN ULLSVIK LA CROSSE WI P�N: 57-026-2-39-09-12-5 05-002- REV TRUST 000140 Legacy PIN: 026939125214 Billing Address: Mailing Address: Map ID: :2.14 ELLEN ULLSVIK ELLEN ULLSVIK Municipality: (026) TOWN O� SAND LAKE REV TRUST REV TRUST STR: S12 T39N R09W 1934 NAKOMIS AVE 1934 NAKOMIS AVE LA CROSSE WI LA CROSSE WI Description: PRT GOVT LOT 2 54603 54603 Recorded 2,520 Acres: Site Address * indicates Private Road Lottery Claims: � 6627N WHITE LN STON 5 876 First Dollar: Yes Waterbody: Whitefish Lake Zoning: (RR1) Residential/Recreational P��pe� Updated: 9/28/2017 One Assessment ESN: 423 2022 Assessment Detail Code Acres Land Imp. Tax Districts Updated: 2/6/2007 RESIDENTIAL 2•520 318,600 44,200 1 State of Wisconsin 57 Sawyer County 2_Year 026 Town of Sand Lake �omparison 2021 2022 Change 572478 Hayward Community Land: 318,600 318,600 0.0% School District �mproved: 44,200 44,200 0.0% 001700 Technical College Total: 362,800 362,800 0.0% Recorded Documents Updated: 4/4/2008 property History WARRANTY DEED N/A Date 386485 Recorded: 8/2/2013 PERSONAL REPRESENTATIVES DEED Date Recorded: 303834 PRD818/445