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/Lx �_t , 6Ca ( tAzt <br /> PRIVY INSTALLATION AGREEMENT—COPY TO BE ATTACHED TO THE SANITARY PERMIT APPLICATION <br /> ProortyOwner(s): Reserved For Recording Date <br /> ,k gAddress: <br /> 5 f-4, I- <br /> Mmo dds �7 <br /> � 9086 <br /> Loca on: <br /> '/,, '/., S T N, R E or W MJRNM COWN <br /> City,Village,Township Of: <br /> Od,-k la y,j W1,400" <br /> Parcel Tax Number. RECEMAND RECORMD <br /> Parce( ID Mc— ozo �3i3-dZ 0 <br /> Legal Description: r JUL3 W <br /> N W uar 2r o SGc1 cf t amu- { et Se��io r1 <br /> %3, o cJ;�S � t P �O /l�i rel, L�Ct�ru? <br /> e/4LcJPs T 11:30 A.M. <br /> REGIS E� <br /> PersorW mformabon you provide may be used for secondary Purpoaes.(P-acy Law,a.15.04(i)(m)l -�t- <br /> 1. No plumbing will installed in the privy. <br /> 2. No plumbing will be installed in the premises served by the privy unless a code compliant soil absorption system or <br /> holding tank 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 Well Lake/Stream Additional County Setbacks <br /> Open Pit 50 Ft 25 Ft Min. 75 Ft / o <br /> Sealed Vault 25 Ft 25 Ft Min. 75 FtS r ` �`�7 Bo <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 <br /> other vermin. Doors should 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 <br /> comply the intent with Comm 83.20, Wis. Adm. Code. Counties may by ordinance, establish minimum sealed vault <br /> sizes and type or construction within the guidelines of Comm 83.20,Wis. Adm. Code. <br /> 7. The privy shall be kept clean and sanitary. The contents of the pit or vault shall be disposed in accordance with NR <br /> 113, Wis. Adm. Code. <br /> 8. This agreement shall be binding on the owner, their heirs and assignees. This documentation shall be recorded by <br /> the register of deeds in a manner which allows its existence to be determined by reference to the property where the <br /> privy is installed. <br /> Printed Owner(s) Name(s): <br /> �� Sl Subscribed and sworn to before me on this date: <br /> K L_A-T:E <br /> Owner(s) Signature: )(,�j M <br /> Notary Public <br /> My commission expires on: FROST�� � <br /> WSAWN M. <br /> Notary Pub He <br /> ' Lry Ceeaetriae Baths la 11.704! <br /> SBD-8432(R.7/98) <br />