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1974/08/22 - SANITARY - SAN - New Non-Press - 3834
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1974/08/22 - SANITARY - SAN - New Non-Press - 3834
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Last modified
3/29/2023 2:13:07 PM
Creation date
3/29/2023 2:10:15 PM
Metadata
Fields
Template:
Property Files v2
Document Date
8/22/1974
Document Type 1
SANITARY
Document Type 2
SAN
Document Type 3
New Non-Press
County Permit Number
3834
State Permit Number
3241
Tax ID
6056
Pin Number
07-012-2-40-15-35-5 05-006-011000
Legacy Pin
012423506700
Municipality
TOWN OF JACKSON
Owner Name
DEBORAH M CONOVER REVOCABLE TRUST
Property Address
3921 MALLARD LAKE RD
City
WEBSTER
State
WI
Zip
54893
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} <br /> • <br /> Fig <br /> ' A. Location of proposed structures and <br /> o )LI existing structures, well, sewage sys- <br /> --- I-- tems, roads, etc., should be sketched <br /> in Fig. A. Include road setback, side <br /> and back yard dimension and loca- <br /> tion and setback from all bodies of <br /> water. If property is located at a <br /> highway intersection, show the inter- <br /> secting highways and the setbacks <br /> a <br /> c required along them and at the in- <br /> ems" aAft( tersection, together with vision clear- <br /> i6'`J eta — F'� ance triangles. <br /> ro PERMIT FEES <br /> Sp <br /> 7, , Land Use $ 1.00 <br /> / Building 5.00 <br /> 7s. Sanitary 10.00 <br /> Well 5.00 <br /> Septic Tank 1.00 (/ <br /> Combination Building, Sanitary <br /> and Well 15.00 r " <br /> ..nditional 0.00 <br /> Ce...A....h..e..CA) ii -,2Cr--7 . - a/Mi !... ,k/ezia,a4 <br /> Si ure of Owner or Date 0 i ,: Admini l ator l <br /> ACTION Site approved (date)Permit Issued (date) g' /- <br /> `" Re ipt No. ,/. Fee $./ � <br /> Septic Tank Permit Issued (date) L}o' - - No. 3.R2. . . Fee $1.00 <br /> Conditional Permit Issued (date) ) No. Fee $ <br /> Certificate of Compliance Issued (date) 1,--7f <br /> Permit Denied (date) for the following reasons <br /> Work Started (date) Work Completed (date) �� <br /> ..0 .. . . .. .Z7'.. p ?l. ����_- 1- � � <br /> INSPECTION Date . . Inspector <br /> Remarks . ./� . <br /> RECORD <br /> Application to Zoning Committee (date) Notice published (date) <br /> Application to Board of Adjustment (date) Notice published (date) <br /> Appealed to Board of Adjustment (date) Notice published (date) <br /> Copy of Notice to DNR (date) <br /> Appeal Heard (date) Decision <br /> Copy of Decision to DNR (date) <br />
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