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Burnett County Zoning Administration <br /> BURNETT COUNTY GOVERNMENT CENTER <br /> Siren, Wisconsin 5488722 County Road Phone (715)349-2138 <br /> Sire <br /> SF.PTi( TANK MAi1`TTF1`TA1`TC'F AC'rRFFI`�F_TT�T <br /> OWNER: (J/1 cl--r�+ a (O/jax� l <br /> ADDRESS:_/7 71/ Owt�'Ci <br /> /d S,T/d <br /> PHONE: (O / 7 5— 6 yQ Sr' <br /> LEGAL DESCRIPTION OF PROPERTY:_SO 90 A, o??O LOT ,( Zy .,-. <br /> �s oG d� �iU�►n,J � d-S Sri �e%�/3o�L yG' c-r r�G D� GI� 2�/ <br /> PROPERTY ADDRESS: j &6--- �o <br /> IMPROPER USE AND MAINTENANCE OF YOUR SEPTIC COULD RESULT IN ITS PREMATURE FAILURE TO <br /> HANDLE WASTE. PROPER USE AND MAINTENANCE SHOULD EXTEND THE LIFE OF THE SYSTEM <br /> CONSIDERABLY. PROPER MAINTENANCE CONSISTS OF PUMPING OUT THE SEPTIC TANK <br /> EVERY 3 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 TREATMENT STAGE IN THE <br /> WASTE DISPOSAL SYSTEM. <br /> BURNETT COUNTY RESIDENTS MAY BE ELIGIBLE TO RECEIVE SOME COST SHARING FUNDING FOR <br /> THE REPLACEMENT OF FAILING SYSTEMS WHEREBY SUCH SYSTEMS WERE IN OPERATION PRIOR TO <br /> JULY 1, 1978. IN PROVIDING ANY COST SHARING, THE STATE DOES REQUIRE THAT OWNERS OF ALL <br /> NEW SYSTEMS AGREE TO KEEP THEIR SYSTEMS PROPERLY MAINTAINED. NATURALLY, THE PROPER <br /> MAINTENANCE IS BENEFICIAL TO YOU AND THE GENERAL PUBLIC. <br /> THE PROPERTY OWNER AGREES TO SUBMIT TO THE COUNTY A CERTIFICATION FORM (TO BE <br /> PROVIDED BY THE COUNTY) EVERY 3 YEARS - SIGNED BY THE OWNER AND SIGNED BY A MASTER. <br /> PLUMBER, JOURNEYMAN PLUMBER, RESTRICTED PLUMBER OR A LICENSED SEPTAGE HAULER. THE <br /> FORM SHALL REQUIRE CERTIFICATION OF THE FOLLOWING: <br /> A. THAT THE ONSITE WASTEWATER DISPOSAL SYSTEM IS IN PROPER OPERATIONAL <br /> CONDITION. <br /> B. THAT AFTER INSPECTION AND AFTER PUMPING (IF NECESSARY), THE SEPTIC TANK <br /> IS LESS THAN 1/3 FULL OF SLUDGE AND SCUM. <br /> I, THE UNDERSIGNED, HAVE READ THE ABOVE REQUIREMENTS AND I AGREE TO MAINTAIN THE <br /> PRIVATE SEWAGE DISPOSAL SYSTEM IN ACCORDANCE WITH THE STANDARDS SET FORTH, HEREIN, <br /> AS SET BY THE WISCONSIN DEPARTMENT OF COMMERCE AND THE BURNETT COUNTY SANITARY <br /> ORDINANCE. <br /> SIGNED; <br /> DATED: <br />