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2016/02/18 - SANITARY - SAN - Other
Burnett-County
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TOWN OF JACKSON
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7395
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2016/02/18 - SANITARY - SAN - Other
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Entry Properties
Last modified
3/5/2020 10:42:43 PM
Creation date
10/4/2017 8:13:00 PM
Metadata
Fields
Template:
Property Files v2
Document Date
2/18/2016
Document Type 1
SANITARY
Document Type 2
SAN
Document Type 3
Other
Tax ID
7395
Pin Number
07-012-2-40-15-13-5 15-255-070000
Legacy Pin
012932507000
Municipality
TOWN OF JACKSON
Owner Name
OSCAR B & SUSAN M MARTINSON
Property Address
28643 GREAT BEAR PASS
City
DANBURY
State
WI
Zip
54830
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Fig' A. Location of proposed structures and <br /> N existing structures, well, sewage sys- <br /> tems, roads, etc., should be sketched <br /> in Fig. A. Include road setback, side <br /> ^] L7 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 /> required along them and at the in. <br /> f s u' r h 3 tersection, together with vision clear- <br /> ance triangles. <br /> Ca PERMIT FEES <br /> Land Use . .. ......... ... ...a 1.00 <br /> Building . .. .. .. . . . . . .. ..... 5.00 <br /> Sanitary . . .. . . . .. .. .. .. ... . 10.00 <br /> Well ... ..... ..... ........ .. 5.00 <br /> Septic Tank . .. ........ ..... 1.00 <br /> Combination Building, Sanitary <br /> and Well .............. 15.00 <br /> i Co tional ..... 10.00 /) <br /> . ' ��' -:�-� ... . ��Q(/`, <br /> Signature of Owner or Agent Date Zo g Administ r <br /> ACTION Site approved date . . . .. . . .. .. .. ..... <br /> Permit Issued((date) .. . . .. .. ../r•_f��: � ReSot No. Fee <br /> Septic Tank Permit Issued (date) . . .... �� Fee $1.00 <br /> Conditional Permit Issued (date) .. . . . .. . . .. ..... . .. . . .. . No. . .. .. . . .. ... Fee a. ...... . .... <br /> Certificate of Compliance Issued (date) . ... .. .. . . .. .. . . . . .. . . .. .. .. .. . . .. . . . . . . . . ...... .. ... <br /> Permit Denied (date) . .. . . . . . . .. . . . . .. . . .. .. .. . for the following reasons ... .. ... . .... .. ...... .. ....... <br /> .. .. .. .. .. .. .. .... .. .. .. .. .. .. .. .. .. . . . . . . . . .. ....... . ..... .. .. .. .. .. .. .... .. . . . . . . .. .. .. . . .. . . . . .... . <br /> Work Started (date) . . . .. .... . . . . .. .... . . . . . Work/Completed (date) . . . . . . . . . ... ..... .. .... <br /> INSPECTION Date ..�.` ``�L �.5. . Inspector <br /> Remarks .S .1 . ; ...... . ... . . . . . :.... .. .. .. .. .. ...... . . .... .. .. .. ..... . . .... <br /> . . . . .. . . .. . .. . . . . . . . . . ....... . .. .. .. ..... . .. . . .. .. .. . . . . . . . . . .. . . .. . . .. .. .. .. . . .. .... ...... . ... .. .. ... <br /> . . . . .. .. .. . . . . . . . . .. . . .... . . . . .. .. .. . . . .. .... . .. .. .. . .. .. .. . . . .. . .. . .. . .. .... . . . . . . .... .. .. .... .. .. ... <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 /> .. .. . ... . . . . . . .... .. . . . .. .. . . ... . . . . .. .. . . . . . . .. .. .. . . . .. .. . . . . . . .. .. .. . . . . . . . . . . . . .. . . .. .. ... . ....... <br /> Copy of Decision to DNR (date) . . . . . . . . . . . . .. .. ..... ... . . . . .. . . . .. .. .. .. . . . . . . . . . . . . . . .. . . . . . . . . . . . . . <br />
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