HomeMy WebLinkAbout032-538-03-2402-SAN-2021-033i � �
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Sawyer County Zoning Admimstration � ___._____ _ ,�
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Hayward, WI 54843 L-'``` J��� � � ?Q�2 � '
Tel:(715)634-8288
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Fax:(715)638-3277 �:'�;,;`,"t;E�'' �"�:.'�..'
URL:httn://sawYercountvgov.or� Z�NIUG ADMI"stii;��l-Nti��;Ji�
Email:zoning c:se c,�a sawvercountygov.org
. � Toll Free:Courthouse/Geneaal Infoimation �
1-877-699-4110
- Sawyer County Zoning and Sanitation "As - Built" Form
Property Owner's Name ��f ►J�i P� ��'r
Fire Number and Road Name L�Z��iS N ��.� �i�ti"�.�r w.x
Plumber's Name ��`L �� .���"'��
Date af Installation �- l� �- � a
Counry Sanitary Permit Number � �— ��
12 Digit Parcel Number ���. J 3� OJ �Ll l7�
Description and Elevation of Benchmark Ce'��� �����' �:� ,r,-,��
'i'ank ly(ani�fat�rnr anrl C`ara�2tv ��<t•✓ J"l'e eQ-`7� 3i� �S��l���'� �i��J
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Setback-Tank to Nearest Lot Line '� ��
Setback-Tank to Nearest Well i�t� �e l 1 �r��t
Setback-Tank to Building u��5 �
Cell Width 1`��
Cell Length � � �
Number of Cells �1�
Setback-Cell to Nearest Lot Line � �
Setback-Cell to Nearest Well ��
Setback-Cell to Building �rt
Setback-Cell to Navigable Water ��
Make and Model of Dispersal Unit �r�
Make and Model of Filter � �
Make and Model of Pump � � I
-Please complete other side-
"As-Built Plot Plan"
Elevation Data
Benchmark 3,8�1 Please include the followine:
Building Sewer �,foo
Tank In � •Location of observation and vent pipes
Tank Out `?,�� •Feet of risers used on tank(s)
Dose Tank In — •L.ocation of benchmark and North arrow
Dose Tank Bottom •Location of a11 components
Header or Manifold — •I.ength of pipe between components
• Distribution Pipe — •Number of chamber units in each cell
System Elevation �— •I.ocation of well,lot lines and road
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