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BURNETT COUNTY ZONING ADMINISTRATION <br /> Statement of POWTS Capabilities <br /> (Private Onsite Waste Treatment System) <br /> I,TOM KELBY understand the POWTS serving the structure 346706 <br /> located at 4878 BERTRAM ROAD,WEBSTER,WI 54893 <br /> was designed for the following capabilities: BURNETT COUNTY <br /> WISCONSIN <br /> Treatment Tank(s)Approx.450 GPD RECEIVED AND RECORDED <br /> Soil Absorption Cell(s)Peak 450 GPD 300 Average GPD <br /> 220 mg/L BOD 150 mg/LL TSS 30 mg/L FOG A P R 3 0 2002 <br /> Permit Number 16794 Year installed 1993 T 2.40 P.M. <br /> The POWTS serving this structure is presently sized to 10(23 F EEDS <br /> accommodate a total of 6 people. <br /> Return To: Burnett County Zoning <br /> Comm 83.54 outlines the management requirements for 7410 County Road K,#102 <br /> these POWTS and I agree to comply with those Siren,WI 54872 <br /> maintenance provisions as they apply to this system. Tax Parcel Number: 014-2204-08-000 <br /> Should my use of the structure described above increase flows above the capacity of the POWTS, I agree <br /> to upgrade my system to meet the standards required in Comm 83. <br /> Should my POWTS fail, as defined in Section 145.01 (16) Wisconsin Statutes, I will obtain the required <br /> permit for the installation of a code-compliant POWTS with the installation completed as ordered. <br /> LEGAL DESCRIPTION: Lot 1 CSM V.12 P.86, located in Government Lot 7, Section 4, T38N R15W, Town of <br /> Lafollette / /"O-P-#- a/U q, DO c UM en t a5-6 9 93 <br /> SIGNATURE(S) <br /> aJid T. l <br /> DATED THIS 5O DAY OFfl _Z <br /> SUBSCRIBED AND SWORN TO BEFORE ME ON THIS DATE: <br /> NOTARY PUBLIC 2 JJ <br /> MY COMMISSION EXPIRES: ,3-5—N2 <br /> THIS INSTRUMENT WAS DRAFTED BY Burma County Zoning Office, 7410 County Road K,#102;Siren, 97 54872;715-349-1138 <br />