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2021/05/17 - SANITARY - SAN - New HT - SAN-21-67
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2021/05/17 - SANITARY - SAN - New HT - SAN-21-67
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Last modified
6/3/2021 8:45:22 AM
Creation date
6/3/2021 8:43:09 AM
Metadata
Fields
Template:
Property Files v2
Document Date
5/17/2021
Document Type 1
SANITARY
Document Type 2
SAN
Document Type 3
New HT
County Permit Number
SAN-21-67
State Permit Number
635104
Tax ID
29001
Pin Number
07-042-2-38-18-25-5 05-007-015000
Legacy Pin
042252505100
Municipality
TOWN OF WOOD RIVER
Owner Name
ALEKSANDAR & RAVAHERE NEDICH
Property Address
22842 SWANSON RD
City
GRANTSBURG
State
WI
Zip
54840
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HOLDING TANK SERVICING CONTRACT <br /> Contract Date: /e -/3 r vZc7 <br /> This contract is made between the Holding Tank Owner and the Pumper. <br /> Holding Tank Owner(s)Name s): Pumper's Name: <br /> Ned, ` <br /> We acknowledge the installation of(a)holding tank(s)on the following property <br /> address: ).-01-(In #Dwt.. CSN lf°j 5 p5 1-S 'n Gov Lo1- . aS-38-1 S <br /> Legal Descriptii�on,:�r <br /> Township Sts ryL <br /> '/., 1/,,Gov't Lot "Section o25-,T N, R 1g W <br /> Lot if Block Subdivision or CSM p <br /> Parcel # - 4-2,2-2-3'- f 8-2caL aco <br /> Tax 10# <br /> I. The owner agrees to file a copy of this contract with the County of \-.QX.vytki as required under Wi <br /> Code SPS 383.21(2)5. <br /> 2. The owner agrees to have the holding tank(s)serviced by the pumper and guarantees to permit the <br /> pumper to have access and to enter upon the property for the purpose of servicing the holding tank(s). <br /> The owner agrees to maintain the all-weather access road or drive so that the pumper can service the <br /> holding tank(s)with the pumping equipment. The owner further agrees to pay the pumper for a <br /> charges incurred in servicing the holding tank(s)as mutually agreed upon by the owner and pumper. <br /> 3. The pumper agrees to submit to the County,reports for the servicing of the holding tank(s) in manner <br /> specified by the County. The pumper further agrees to include the following in the report: <br /> a. The name and address of the person responsible for servicing the holding tank; <br /> b. The name of the owner of the holding tank; <br /> c. The location of the property on which the holding tank is installed; <br /> d. The sanitary permit number issued for the holding tank; <br /> c. The dates on which the holding tank was serviced; <br /> The volumes_in_tallons of the-contents pumpcd from the holding tank for e-'ch s ervicing; <br /> g.The disposal sites to which the contents from the holding tank were delivered. <br /> h.Condition of holding tank and components at time of inspection. <br /> 4. This agreement will remain in effect until the owner or pumper terminates this contract. In the event <br /> of a change in this contract,the owner agrees to tile a copy of any changes to this service contract or a <br /> copy of a new service contract with the municipality and the County named above within ten(10) <br /> business days from the date of change to this service contract. <br /> Owner(s)Names(s)(Print) Owner's S.mature(s) <br /> /r_G✓cam' .ta <br /> Pumper's Name(Print) Pumpe 's Signal`e <br /> • Pumper's Registration Number <br /> 8=-!i _ - <br />
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