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Permit #17075 <br /> Burnett County Zoning Administration <br /> BURNETT COUNTY GOVERNMENT CENTER <br /> 7410 County Road K, #102 Phone (715) 349-2138 <br /> Siren, Wisconsin 54872 <br /> SEPTIC TANK MAI/NTENANCE /AGREEMENT <br /> OWNER� f/-Gf2 L G(/�✓r// �/ <br /> ADDRESS 02 G� ✓ r i/ /li�/7r„zn� (� S4/U/7 <br /> PHONE: <br /> RE: PROPERTY LOCATED IN THE 1/4 OF I/4 OR GOV'T. LOT_, <br /> OR LOT BLOCK SUBDIVISION <br /> SECTION__T N-R___W, TOWNSHIP OF <br /> IMPROPER USE AND MAINTENANCE OF YOUR SEPTIC COULD RESULT IN ITS <br /> PREMATURE FAILURE TO HANDLE WASTE. PROPER USE AND MAINTENANCE <br /> SHOULD EXTEND THE LIFE OF THE SYSTEM CONSIDERABLY. PROPER <br /> MAINTENANCE CONSISTS OF PUMPING OUT THE SEPTIC TANK EVERY 2 TO 3 <br /> YEARS OR AS NEEDED BY A LICENSED SEPTIC TANK PUMPER. WHAT YOU PUT <br /> INTO THE SYSTEM CAN AFFECT THE FUNCTION OF THE SEPTIC TANK AS A <br /> TREATMENT STAGE IN THE WASTE DISPOSAL SYSTEM. <br /> BURNETT COUNTY RESIDENTS MAY BE ELIGIBLE TO RECEIVE SOME COST <br /> SHARING FUNDING FOR THE REPLACEAlF_NT OF FAILING SYSTEMS WHEREBY SUCH <br /> SYSTEMS WERE IN OPERATION PRIOR TO JULY 1, 1978. IN PROVIDING ANY <br /> COST SHARING, THE STATE DOES REQUIRE THAT OWNERS OF ALL NEW SYSTEMS <br /> AGREE TO KEEP THEIR SYSTEMS PROPERLY MAINTAINED. NATURALLY, THE <br /> PROPER MAINTENANCE IS BENEFICIAL TO YOU AND THE GENERAL PUBLIC. <br /> THE PROPERTY OWNER AGREES TO SUBMIT TO THE COUNTY A CERTIFICATION <br /> FORM (TO BE PROVIDED BY THE COUNTY) EVERY 3 YEARS - SIGNED BY THE <br /> OWNER AND SIGNED BY A MASTER PLUMBER, JOURNEYMAN PLUMBER, <br /> RESTRICTED PLUMBER OR A LICENSED SEPTAGE HAULER. THE FORM SHALL <br /> REQUIRE CERTIFICATION OF THE FOLLOWING: <br /> A. THAT THE ON-SITE WASTEWATER DISPOSAT_ <br /> SYSTEM IS IN PROPER OPERATION CONDITION. <br /> B. THAT AFTER INSPECTION AND AFTER PUMPING <br /> OF NECESSARY), THE SEPTIC TANK IS LESS <br /> THAN 1/3 FULL OF SLUDGE AND SCUM. <br /> I, THE UNDERSIGNED, HAVE READ THE ABOVE REQUIREMENTS AND I AGREE TO <br /> MAINTAIN THE PRIVATE SEWAGE DISPOSAL SYSTEM IN ACCORDANCE WITH THE <br /> STANDARDS SET FORTH, HEREIN, AS SET BY THE WISCONSIN D PART OF <br /> NATURAL RESOURCES. <br /> SIGNED: <br /> DATE: 02 <br /> f <br />