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2021/06/11 - SANITARY - SAN - New HT - SAN-21-128
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2021/06/11 - SANITARY - SAN - New HT - SAN-21-128
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Last modified
10/12/2021 12:01:57 PM
Creation date
10/7/2021 12:24:43 PM
Metadata
Fields
Template:
Property Files v2
Document Date
6/11/2021
Document Type 1
SANITARY
Document Type 2
SAN
Document Type 3
New HT
County Permit Number
SAN-21-128
State Permit Number
635165
Tax ID
23711
Pin Number
07-034-2-37-18-20-5 05-004-017000
Legacy Pin
034152002360
Municipality
TOWN OF TRADE LAKE
Owner Name
ADAM C & KAYLA R BISTRAM
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HOLDING TANK SERVICING CONTRACT <br /> Contract Date. q- a, <br /> This contract is made between the Holding Tank Owner and the Pumper. <br /> Holding Tank Owner(s)Name(s): Pumper's Name: <br /> We acknowledge the installation of(a)holding tank(s)on the followiz property(Provide legal <br /> description and computer number): {. d4 6 t�/ii1 1/ rqd 5tc-, ?" f tJ <br /> d j" ool-6l-7000 ! S <br /> 1. The owner agrees to file a copy of this contract with the County of Burnett,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 /> e. The dates on which the holding tank was serviced; <br /> f. The volumes in gallons of the contents pumped from the holding tank for each servicing; <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 file 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 /> Owners)Names(s)(Print) Owner's Signature(s) <br /> 11 I l s raA,,, <br /> K41l' 1 61 <br /> Pumper's LName t) Pump is Signatur <br /> Pumper's R stration Number <br />
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