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Permit #17170 <br /> Burnett County Zoning Administration <br /> BURNETT COUNTY GOVERNMENT CENTER <br /> 7410 County Road K, #102 Phone (715) 349-2138 <br /> Siren, Wisconsin 54872` SEPTIC TANK MAINTENANCE AGREEMENT <br /> OWNER: �Y�H hI f. MA� IAtJtJt �/�c�2T1-LY <br /> ADDRESS: �ZL6�>G �T <br /> PHONE:_ 0 ( Z — L4 5 Co _ O 3 Z ) <br /> u,-r i csr-t V .IU <br /> RE: PROPERTY LOCATED IN THE _1/4 OF _1/4 OR GOVT. LOTP..$-7 <br /> OR LOT BLOCK SUBDIVISION _ <br /> SECTION�T 40 N-R k 5 W, TOWNSHIP OF J f+c K So�► �'"^ <br /> LA KfZ <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 REPLACEMENT 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 DISPOSAL <br /> SYSTEM IS IN PROPER OPERATION CONDITION. <br /> B. THAT AFTER INSPECTIjON AND AFTER PUMPING <br /> (IF 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 DEPARTMENT OF <br /> NATURAL RESOURCES. <br /> SIGNED: <br /> DATE: � 'Z/f —`� 3 I <br /> AUG 2 5 199 <br />