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PRIVY INSTALLATION AGREEMENT <br /> To be completed in black ink. (Attach copy to Non-Plumbing Sanitary Application) <br /> Property Owner(s): <br /> Patrick and Cindy Henderson <br /> Mailing Address: FOR REFERENCE <br /> 417 Whiskey Road SW Isanti Mn 55040 ONLY <br /> Property Address: <br /> 6995 Minerva Landing Danbury WI 54830 <br /> Location rr <br /> '/4, '/4, S 35 ,T 'A\ N, R \i0 W <br /> Town Of: <br /> Swiss <br /> Parcel Identification Number: <br /> 07-032-2-41-16-35-3 03-000-016000 <br /> Legal Description: , 2 , <br /> Lo-\ iL CSM-#141-177 Q2 <br /> Cs' SW) X121125 <br /> Tax ID:33596 <br /> Return To: Burnett County Land Services Dept. <br /> 7410 County Road K,#120 <br /> Siren,WI 54872 <br /> 1. No plumbing will be installed in the privy. <br /> 2. No plumbing will be installed on the premises served by the privy unless:a code compliant soil absorption system or holding tank <br /> 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 Building Lake/Stream Additional Setbacks <br /> Open Pit 50 Ft 10 Ft Min. 75 Ft 25 Ft to all lot lines <br /> Sealed Pit 25 Ft 5 Ft Min. 75 Ft 25 Ft to all lot lines <br /> 4. Privies for public buildings shall comply with Wis.Adm.Code.SPS 391. <br /> 5. Privies used for one-and-two-family purposes shall be constructed in such a manner so as to exclude flies,rats and other vermin. Doors should be <br /> 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 comply with intent of Wis. <br /> Adm.Code SPS 383.20&SPS 391. <br /> 7. SPS 391.12 Privies—requires the storage chamber of a vault privy to conform with SPS 384.25 requirements. The vault shall have a minimum <br /> storage capacity of 200 gallons or one cubic yard. <br /> 8. The privy shall be kept clean and sanitary. The contents of the pit or vault shall be disposed in accordance with NR 113,Wis.Adm.Code. <br /> 9. This agreement shall be binding on the owner,their heirs and assignees. This documentation shall be recorded by the register of deeds in a <br /> manner which allows its existence to be determined by reference to the property where the privy is installed. <br /> 10. The property owner shall notify the County for inspection immediately after the non-plumbing sanitary system has been constructed. <br /> Printed Owner(s)Name(s): Subscribed and sworn to before me on this date: <br /> Cindy Henderson 1- ^ _ _ 14I 2.021Owner(s) Signature: Notary Public: `t <br /> &7y/1/1/ 1k I ✓ Lcei1'1 ivl i <br /> My commission expires on: <br /> iOM3112132Z <br /> Drafted By: Burnett County Land Services Department Date: <br /> Personal information you provide may be used for secondary purposes.[Privac • <br /> ` ' KAYLEEN R FAGERSTROM <br /> `•� `'' NOTARY PUBLIC-MINNESOTA <br /> : - " My Commission Expires Jan.31,2022 <br /> ■ ■ <br />