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2023/11/15 - SANITARY - SAN - Other - SAN-23-264
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2023/11/15 - SANITARY - SAN - Other - SAN-23-264
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Last modified
1/9/2025 4:00:54 PM
Creation date
1/9/2025 3:00:47 PM
Metadata
Fields
Template:
Property Files v2
Document Date
11/15/2023
Document Type 1
SANITARY
Document Type 2
SAN
Document Type 3
Other
County Permit Number
SAN-23-264
State Permit Number
656853
Tax ID
9256
Pin Number
07-014-2-38-15-04-5 05-003-013000
Legacy Pin
014220401300
Municipality
TOWN OF LAFOLLETTE
Owner Name
STEVEN M & BARBARA E BOLLUM
Property Address
24740 FOSMO DR
City
WEBSTER
State
WI
Zip
54893
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PAGE 1 OF 4 <br /> Holding Tank Plan <br /> Index & Cover Sheet <br /> Component Manual Design References: <br /> Holding Tank Version 2.1 (May 2022-2027) <br /> Pg 1 of 4 Index & Cover Sheet <br /> Pg 2 of 4 Plot Plan <br /> Pg 3 of 4 Holding Tank Specifications <br /> Pg 4 of 4 Management Plan <br /> Attachments: Enclosures: <br /> POWTS Application for Review <br /> Soil Evaluation Report & Site Map (if applicable) <br /> Holding Tank Pumping Contract if applicable) <br /> Holding Tank Agreement if applicable) <br /> Project Name / Description <br /> Holding tank addition <br /> Owner Name(s): STEVEN M & BARBARA E BOLLUM Phone: 612 _590 _6643 <br /> Owner Address: 3141 12ST NW NEW BRIGHTON MN Zip: 55112 <br /> Project Address: 24740 FOSMO DR <br /> Govt. Lot: 1/4 of 1/4, Section 4 T 38 N-R 15 E❑or W❑✓ <br /> Township: LAFOLLETTE County: Burnett <br /> Project Parcel ID #: 07-014-2-38-15-04-5 05-003-013000 <br /> Designer Information <br /> Designer Name: Luke Schmitz Phone: 715 -520 -2434 <br /> Designer Address: PO Box 160 Shell Lake WI Zip: 54871 <br /> E-mail: digupnorth@gmail.com <br /> License Number: 884121 <br /> Remarks: <br /> LOT 2CSMV1P64 <br /> Signature: �- Date: 11-7-23 <br /> Original signatur required on each lutakitted copy. <br />
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