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2003/12/11 - SANITARY - SAN - Other
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TOWN OF JACKSON
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6129
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2003/12/11 - SANITARY - SAN - Other
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Last modified
3/5/2020 10:21:03 PM
Creation date
9/28/2017 12:01:15 AM
Metadata
Fields
Template:
Property Files v2
Document Date
12/11/2003
Document Type 1
SANITARY
Document Type 2
SAN
Document Type 3
Other
Tax ID
6129
Pin Number
07-012-2-40-15-36-5 05-006-013000
Legacy Pin
012423606800
Municipality
TOWN OF JACKSON
Owner Name
TAMI & ROGER VIERNOW
Property Address
3741 MALLARD LAKE RD
City
WEBSTER
State
WI
Zip
54893
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Safety and Buildings <br /> 15837 USH 63 <br /> HAYWARD WI 54843-8107 <br /> Nvisc <br /> Tommy G.Thompson,Governor <br /> O sI n Brenda J.Blanchard,Secretary <br /> Department of Commerce <br /> March 02, 1999 <br /> CUST ID No.11599 ATTN:POWTS INSPECTOR <br /> ZONING OFFICE <br /> DANIELS PLUMBING&HEATING INC BURNETT COUNTY <br /> PO BOX 316 7410 CTH K#102 <br /> SIREN WI 54872 SIREN WI 54872 <br /> RE: CONDITIONAL APPROVAL <br /> APPROVAL EXPIRES: 03/02/2001 Identification Numbers <br /> Transaction ID No.210758 <br /> Site ID No. 167230 <br /> SITE: Please refer to both identification numbers, <br /> Site ID: 167230 above,in all correspondence with theagency. <br /> BURNETT County,Town of JACKSON;3741 MALLARD LAKE RD,WEBSTER 54893 <br /> Government Lot(s) 6, 536,T40N,R15W <br /> Facility:TAMMY VIERNOW RESIDENCE SEPTIC SYSTEM 3741 MALLARD LAKE RD,WEBSTER 54893 <br /> FOR: <br /> HOLDING TANK,300 GPD <br /> Object Type:POWT System Regulated Object ID No.:450916 ROY <br /> The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes Condit <br /> and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner,as defined in A P <br /> chapter 101.01(10),Wisconsin Statutes,is responsible for compliance with all code requirements. A <br /> PR <br /> DEPARTMENT <br /> The following conditions shall be met during construction or installation and prior to occupancy or use: 01 Of SAFE' <br /> 1. This plan action is subject to designer comments on the plan. <br /> 2. A meter,with remote reading device,shall be installed by a properly licensed plumber,on the water SEE CORRE <br /> system,that adequately measures the amount of water used by the structure,excluding hose bibs and <br /> wall hydrants,which do not discharge into the sanitary system per COMM 83.18(10). <br /> A copy of the approved plans,specifications and this letter shall be on-site during construction and open to <br /> inspection by authorized representatives of the Department,which may include local inspectors. All permits <br /> required by the state or the local municipality shall be obtained prior to commencement of <br /> construction/installation/operation. <br /> Inquiries concerning this correspondence may be made to me at the telephone number listed below,or at the address <br /> on this letterhead. <br /> Sincerely, DATE RECEIVED 02/12/1999 <br /> FEE REQUIRED$ 60.00 <br /> CZ- 2 FEE RECEIVED$ 60.00 <br /> PATRICIA L SHANDORF,POWTS PLREVIEWER BALANCE DUE $ 0.00 <br /> Integrated Services <br /> (715)634-7810, FAX:(715)634-5150,M-F 7:45 AM-4:30 PM <br /> PSHANDORF@COMMERCE.STATE.WLUS WiSMART code: 7633 <br />
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