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2011/05/02 - SANITARY - SAN - Other
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TOWN OF JACKSON
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6602
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2011/05/02 - SANITARY - SAN - Other
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Last modified
3/5/2020 10:36:02 PM
Creation date
10/3/2017 7:28:59 PM
Metadata
Fields
Template:
Property Files v2
Document Date
5/2/2011
Document Type 1
SANITARY
Document Type 2
SAN
Document Type 3
Other
Tax ID
6602
Pin Number
07-012-2-40-15-13-5 15-124-013000
Legacy Pin
012922501300
Municipality
TOWN OF JACKSON
Owner Name
DUSTIN J & CHASTITY A EVENSTAD
Property Address
28715 TREASURE ISLAND RD
City
DANBURY
State
WI
Zip
54830
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COUNTY PEfMT 4 <br /> SANITARY INSP' EC' TION REPORT <br /> Owner's Tae G Location <br /> Address <br /> State Permit !�_��`��.� Installer <br /> SEPTIC TANK 7 <br /> Septic Tank Z17btal Gallons Number of Tanks,, . , <br /> Holding Uwe Tbtal Mzber of Tanks <br /> Material: Concrete steel.____ F'i <br /> Cast Piping to & from Tank : � <br /> Inlet Leaded: Yes ' ✓- ' <br /> Outlet Leaded: Yeo No <br /> Tank Sealed Properly: Yes No <br /> Tank Appears Level: Yes NO <br /> HOLDING TANK ONLY: <br /> Warning Device Located: Yes . NO <br /> Vent Yes No <br /> Locking Device: Yes NO <br /> DRAINFIELD <br /> Absorption Bed: Length :H Width /f�� Depth Z <br /> Absorption Trench: Linear. Width Dep <br /> Absorption Pit: Depth aside Diamb_MW7. <br /> Soil Appears as in ER-115: Yes 4— NO Explain: <br /> Distance t0 Bld&: �"�'-'7`-- Well <br /> Aggregate 3/4 - 2-1/2 Inch: Yes X- NO <br /> 32 Inches Below Tile: <br /> 2 Inches Above Tile: Yes NO <br /> Covering: Building Paper Marsh Hay <br /> Vent Pipe Minimum 4" C.I.: Yes t-- No <br /> AS-BUILT SAME AS APPLICATION: Yes /-- No # <br /> a If As-Built differs from system shown on PLS-67, draw a diagram of the system as <br /> built on the reverse side of this report. <br /> INSPB=OR <br /> DATE <L" <br />
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