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2013/11/26 - SANITARY - SAN - Other
Burnett-County
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TOWN OF JACKSON
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4959
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2013/11/26 - SANITARY - SAN - Other
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Entry Properties
Last modified
3/5/2020 8:50:37 PM
Creation date
10/2/2017 8:43:18 AM
Metadata
Fields
Template:
Property Files v2
Document Date
11/26/2013
Document Type 1
SANITARY
Document Type 2
SAN
Document Type 3
Other
Tax ID
4959
Pin Number
07-012-2-40-15-01-5 05-003-019000
Legacy Pin
012420103900
Municipality
TOWN OF JACKSON
Owner Name
ROBERTA R DASCALOS
Property Address
3704 MEYERS RD
City
DANBURY
State
WI
Zip
54830
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Conran <br /> Safety and Buikfinp Division Lqo/( <br /> 201 W.Wastl-it M Ave.,P.O.Box 7162 Smriury Permit Number No be Filled in by Cal <br /> Madson,M 53707-7162 <br /> s; a8 <br /> Sanitary Permit Application Sane Tarrecoon Number <br /> In neemdarce wide SPS 38311(2).W s.Adm_Cods suGnision archer krm w me appo,Wmc 5ovrnrmmW anis <br /> rcauircalmarm oGainirgaamrvery hermit Nat:Applirmim(sfa aacowned POVMnabazbods¢dw Pm as Add.prdiReremdunrmili,address) <br /> rte ucpenmem o(Sa4n'eM Pmresiaml suricz. Rrsaml iNnrrmlim yw provide mar he usW fm xardary <br /> s in aeeoedam'e vied Ne Priv Ian,s.15 U4(1 mk Stab. <br /> 1. A riexti¢n lnrorma[ion-Plm.Priet All inrorma[iom -570,V <br /> Property Onner's Name Parcel: <br /> �4sG4 �5 C 3h O/Z420lo 3yoo. <br /> Propern omtr:Mailirg.Addres p� proper,w inm <br /> lb 2ol cSax(UQa w Tlti cost 3 <br /> Gn.Sm¢ I ////// Lecii-,��CC�ode, Phar Number Y., %, Sermon <br /> Ga <NIrG eAJ ✓511* T ti0 N: R Il`i e <br /> It.Type of Building(check all that apply) fat# <br /> IN I ar 2 Family D..elfim-Numbcr of Bedrooms SAdivinon Name <br /> Block# <br /> D Publ ic(Commercixl-Describe Use <br /> ❑Crry pf <br /> ❑$ran Owned-De Le Bee CSM Numbm 0 <br /> �1 vilhke Of <br /> V1 01 q ,Tana( SRcksn^i <br /> IH.Type or Permit: (Cheekanly¢nelwzon(ine A. Completelme Birappliabfe) OZ.O -d� (._"n4:rm3- <br /> `'' 0 New Syxtm ?rReplacemem Sy bcm m Treece maHohn,Took Re lace nuuOM' ❑OrIV Modd tion w ee,.m_5 <br /> ¢ sem(exploin) <br /> 9. BB=1 Rcnewzl D Permit Revision D Ching aPtmrbm D Pm ul TarrefrreaNen lrst Perms Number and pee Issued <br /> flelme Expino. Owe <br /> Il'.Tv a or POtt'fS Svstem/Com unenOD ice: (Check ail that apply) <br /> K Non-Pressurized In{rtmnd D Memmmol laG mntl 0A rvY ❑Mmmd>26 u.afvivde.l ❑Mound 124 in o(suibbie mil <br /> D Holding Tank ❑Odtr pisyervl Cmnpatm(ecpUin) ❑PrGRalmem Devic(explun) <br /> Y. pis cr,. r .lmenl Arta I¢formalian: <br /> Desi¢n Ft. Bpd) Design Soil Applianion Rme(epdx0 Diq Ara Re'loned(So DizyvsA Ara Prepmed(A Sysrcm Dewtian <br /> 2 d 9Z6 41?8. 4 . <br /> \'I.Tank Into Cepoanm Toed #a( Mamafamum <br /> Babes Callora Umb <br /> I:en TaN:s Faim'rg Tmb e ` `y-' - � <br /> ScyricrcfWlit Tek nO e <br /> Oaol;CamW D <br /> V1I.R6pansibifinSta¢ment 1, mme amebed p n— <br /> I'lz Nol�r Bvnm Mem Number <br /> er (//�jf�rG�i� 5/95L/ 7/3 66 70 <br /> Plumber's Addme;(�Sml'- Cie" 2ipC ) <br /> olao Jg1n Z:1 WeL�,I&IL l:54,5? <br /> VULCmnmtrme arlmcmtDaeonly <br /> ❑Appmvcd DDisappmvedP<rmiz Fa Dve lined Lzwin^f oasipnuoe <br /> / <br /> ❑ow,Krc.'em Remanr Beam S.3Z5!T <br /> IN.Conditions or AppravaVRemnma for Disupproval <br /> o MEYER_ <br /> \ma4mromsxu¢6mzorrhr annt>ed anCvhw rhe C—aelo n>a+et leadenarea 111. v1UG al 2013 <br /> SND-6398(R. I i/I I) <br /> BURNETT COUNTY <br /> ZONING <br />
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