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2022/05/19 - SANITARY - SAN - New HT - SAN-22-275
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2022/05/19 - SANITARY - SAN - New HT - SAN-22-275
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Last modified
1/5/2023 3:22:18 PM
Creation date
1/5/2023 3:19:38 PM
Metadata
Fields
Template:
Property Files v2
Document Date
5/19/2022
Document Type 1
SANITARY
Document Type 2
SAN
Document Type 3
New HT
County Permit Number
SAN-22-275
State Permit Number
640613
Tax ID
6030
Pin Number
07-012-2-40-15-35-5 05-008-018000
Legacy Pin
012423504300
Municipality
TOWN OF JACKSON
Owner Name
JAY WILLIAM HARMS
Property Address
4140 MALLARD LAKE RD
City
WEBSTER
State
WI
Zip
54893
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Hopkins Sand and Gravel <br /> 27760 State Rd 35 Webster WI 54893 <br /> Phone(715)866-4157 <br /> Fax(715)866-8104 <br /> INDEX SHEET <br /> PROPERTY OWNER(S)= •J'y Ha.rri <br /> PROJECT NAME= 5(4 <br /> PROJECT LOCATION= <br /> Street Address <br /> �(vd /r1OffAegi 414 /2I <br /> 1/41/4,Section,Town,Range(for POWTS submittals) <br /> 3S' 'MN ffk' J a c l c i ae) <br /> Municipality <br /> /3 G.r n e 7� <br /> County <br /> CONTENTS PAGE 1: o;/ /?.c p a •-1 <br /> PAGE 2: <br /> PAGE 3: /,"d f //a <br /> PAGE 4: <br /> PAGE 5: f t// G v o J s j <br /> PAGE 6: /-; /f „ .s/pr <br /> PAGE 7: M A. e h„r n r p/A <br /> PAGE 8: �/ f <br /> PAGE 9: <br /> PAGE 10: <br /> PAGE 11: <br /> PAGE 12: <br /> PAGE 13: <br /> PAGE 14: <br /> PAGE 15: <br /> NAME: Richard Hopkins SIGNED: 1 /) <br /> DATED: Y- 3►- 41- 1 <br /> CREDENTIAL NUMBER: 225851 <br /> COMP.MANUAL USED—Holding Tanks SBD- 10855-P(N.03/07;R 01/12) <br /> Mound SBD- 10691-P(N.01/01;R. 10/12) <br /> In-Ground Sys SBD- 10705-P(N.01/01;R. 10/12) <br /> Pressure Sys SBD- 10706-P(N.01/01;R. 10/12) <br />
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