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PRIVY INSTALLATION AGREEMENT (Copy To Be Attached To The Sanitary Plication) <br /> (To be completed in black ink <br /> Property Owner(s): Reserved For Recording Date <br /> Mailing Address: 390954 <br /> Location: / q BURNETTT COUNTY <br /> NE '%, 5e '/y So�)o ,T31N,R /11W MSCO"N <br /> City,Village,Township Of- nom-,ee'n On RECENED AND RECORDS <br /> Parcel Tax Number: 11 I MAY 1 7 2007 <br /> 0[S-33ab-(I-( DD 9:30 A.M. <br /> Legal Description: 9 <br /> ( ofi a c5m r. aop • a('9 <br /> (Yl et p R (il R F EEDS <br /> Personal information you provide may be used for secondary purposes.[Privacy Law,s. 1504(1)(m)] Return To: Burnett County Zoning <br /> 7410 County Road K,#102 <br /> 1. No plumbing will be installed in the privy. Siren,Wl 54872 <br /> 2. No plumbing will be installed in the premises served by the privy unless a code compliant soil absorption system or holding tank <br /> exists,or a valid sanitary permit to install such a system has been issued. <br /> 3. A privy vault/pit shall maintain minimum setbacks as specified in Table 1. <br /> Table 1 Well Building Lake/Stream Additional County Se backs <br /> Open Pit 50 Ft 1017t Min. 75 Ft 25 Ft to all lot lines <br /> Sealed Pit 25 Ft 5 Ft Min. 75 Ft 25 Ft to all lot lines <br /> 4. Privies for public buildings shall comply with ILHR 52.63,Wis.Adm.Code. <br /> 5. Privies used for one-and-two-family purposes shall be constructed in such a manner so as to exclude flies,rats and other vermin. Doors should <br /> be self-closing and vault ventilators should terminate at least one foot above the roof. <br /> 6. A privy vault shall be constructed of watertight plastic,fiberglass,coated steel or monolithic concrete. Materials shall comply the intent with <br /> Comm 83.20,Wis. Adm.Code. <br /> 7. Comm 91.12 Privies—requires the storage chamber of a vault privy to conform with Comm 84.25 requirements. The vault shall have a minimum <br /> storage capacity of 200 gallons or one cubic yard. <br /> 8. The privy shall be kept clean and sanitary. The contents of the pit or vault shall be disposed in accordance with I IR 113,Wis.Adm.Code. <br /> 9. This agreement shall be binding on the owner,their heirs and assignees. This documentation shall be recorded b e the register of deeds in a <br /> manner which allows its existence to be determined by reference to the property where the privy is installed. <br /> 10. The property owner shall notify the County for inspection immediately after the non-plumbing sanitary system has been constructed. <br /> Printed Owner(s)Name(s): Subscribed and sworn to before me on this date: <br /> Aner(s)'Signature: Notary Public <br /> My commission expires on: �3— J( <br />