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2022/05/26 - SANITARY - SAN - Repl Non-Press - SAN-22-97
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2022/05/26 - SANITARY - SAN - Repl Non-Press - SAN-22-97
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Last modified
1/9/2023 8:43:22 AM
Creation date
1/9/2023 8:41:15 AM
Metadata
Fields
Template:
Property Files v2
Document Date
5/26/2022
Document Type 1
SANITARY
Document Type 2
SAN
Document Type 3
Repl Non-Press
County Permit Number
SAN-22-97
State Permit Number
643487
Tax ID
5162
Pin Number
07-012-2-40-15-07-5 05-011-019000
Legacy Pin
012420710730
Municipality
TOWN OF JACKSON
Owner Name
KATHLEEN C QUIRK
Property Address
28951 SEIBEN RD
City
DANBURY
State
WI
Zip
54830
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PAGE 1 OF 4 <br /> In-Ground Gravity Plan <br /> Index & Cover Sheet <br /> Component Manual Design References: <br /> Version 2.0, SBD-10705-P (N.01/01, R. 10/12) <br /> Pg 1 of 4 Index & Cover Sheet <br /> Pg 2 of 4 Plot Plan <br /> Pg 3 of 4 Dispersal Area Cross-Section & Plan View <br /> Pg 4 of 4 Management Plan <br /> Attachments: Enclosures: <br /> 1' °ev(ous f=iVegVtit< POWTS Application for Review <br /> Soil Evaluation Report & Site Map <br /> Project Name / Description <br /> Owner Name(s): KATHLEEN C. QUIRK Phone: 715 _ 791 _ 8174 <br /> Owner Address: 5557 FREMONT AVENUE S., MPLS., MN Zip: 55419 <br /> Project Address: 28951 SEIBEN ROAD <br /> Govt. Lot: 11 1/4 of 1/4, Section 07 T 40 N-R 15 E or W ✓ <br /> Township: JACKSON County: BURNETT <br /> Project Parcel ID#: 07-012-2-40-15-07-5 05-011-019000 <br /> Designer Information <br /> Designer Name: MARY JO HUPPERT Phone: 715 _ 426 _ 1775 <br /> Designer Address: 28497 KING ARTHUR'S CT., DANBURY Zip: ,,11 $30 <br /> E-mail: hollisterdesign@outlook.com .,,� ,�. 4 <br /> License Number: <br /> 1859 - 007 ° <br /> Remarks: g • i► :, . rzT <br /> add a t <br /> t.�'�_�? '• Ytt' rkl::LS <br /> Signature: tit G ` ' ' Date: 09 - 20, 2021 <br /> g oaal nature required ach submitted copy. <br />
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