1993/04/22 - SANITARY - SAN - Other

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Permit #16856 Burnett County Zoning Administration BURNETT COUNTY GOVERNMENT CENTER 7410 County Road K,#102 Phone(715)349.2138 Siren,Wisconsin 54872 /J SEPTIC TANK MAINTENANCE AGREEMENT OWNER: fCu �E / DATE: ADDRESS: 4600 PHONE: RE: Property located in the 1/4 of 1/4 or Gov't. Lot Section or Lot y, Block Subdivision �5 1 �/ esu_ T N-R W Township of c Burnett County, Wisconsin. Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper use maintenance should extend the life of the system consider- ably. Proper maintenance consists of pumping out the septic tank every 2 to 3 years or as needed by a licensed septic tank pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. Burnett County residents may be eligible to receive some cost share funding for the replacement of failing systems whereby such systems were in operation prior to July 1, 1978. In providing any cost sharing, the state does require that owners of all new systems agree to keep their systems properly maintained. Naturally, the proper mainten- ance is beneficial to you and the general public. The property owner agrees to submit to the county a certification form (to be provided by the county) every 3 years - signed by the owner and signed by a master plumber, journey- man plumber, restricted plumber, or a licensed septage hauler. The form shall require certification of the following: a. That the on-site wastewater disposal system is in proper operation condition. b. That after inspection and aft-er pumping (if necessary) , the septic tank is less than 1/3 full of sludge and scum. I, the undersigned, have read the above requirements and I agree to maintain the private sewage disposal system in accordance withthe dards set forth, herein, as set by the Wisconsin Department of Natural Resources. Signed: Date: �/ ZH t i