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2024/08/29 - SANITARY - SAN - Repl HT - SAN-24-210
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2024/08/29 - SANITARY - SAN - Repl HT - SAN-24-210
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Last modified
2/11/2025 5:00:27 PM
Creation date
2/11/2025 4:07:34 PM
Metadata
Fields
Template:
Property Files v2
Document Date
8/29/2024
Document Type 1
SANITARY
Document Type 2
SAN
Document Type 3
Repl HT
County Permit Number
SAN-24-210
State Permit Number
662066
Tax ID
5241
Pin Number
07-012-2-40-15-13-5 05-001-012000
Legacy Pin
012421301610
Municipality
TOWN OF JACKSON
Owner Name
HENRY E FARRIOR JR
Property Address
28730 BRIDGE RD 28728 BRIDGE RD
City
DANBURY
State
WI
Zip
54830
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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 Holdinq 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 appiicable) <br /> Holding Tank Agreement if applicable) <br /> Project Name / Description <br /> Owner Name(s): 4wy Artibr Phone: -Owner Address: 0873/ 1sr;cC�P,�/ / r ry w,. Zip: 1�830 <br /> Project Address: 2P,46 <br /> Govt. Lot: 1/4 of 1/4, Section, T �/y N-R /S E❑or W Q <br /> Township: 74ckA%1J County: 'do"ivci-t' <br /> Project Parcel ID #: 07-olZ-Z-kD-��1�S off'-en/-o(zd6d <br /> Designer Information <br /> Designer Name: ze912o 1,i d6- Phone: 7/5-- 5'6�- dZo-Z <br /> Designer Address: <br /> _•�Aoo 'n.�L i � Zip: St� <br /> E-mail' 1 ��I�/��1"�►� `l�lGd.lE�/�'� This space reserved for approval stamp. <br /> License Number: <br /> Remarks: <br /> Signature: Date: 6L_,T�f <br /> Original signature required on each submitted copy. <br />
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