2016/01/12 - SANITARY - SAN - Other

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AT-Risk POWTS Servicing Contract Contract Date: This contract is made between the Owner of the At-Risk POWTS and a licensed Service Provider AT-Risk POWTS Owner(s)Name(s) Service Provider Name(s) David Ries A:rru� i We acknowledge the installation of a Private Onsite Wastewater Treatment System considered being At- Risk pursuant to the Department of Safety&Professional Services(formerly Commerce)High Strength Wastewater Policy of April 1,2009,on the following property: Site Address: 7402 County Rd. U Legal Description: S1/2-SE 1/4-NE 1/4 Lying East of the railroad right of way Sec.20 T40N-R16W Town of Oakland in Burnett County. Parcel I.D.Number: 07-020-2-40-16-20-1 04-000-014000 State Plan Transaction Number: • The Owner agrees to file a copy of this contract required under the provisions of SPS 383.52(1) (c)with the governmental unit responsible for the regulation of POWTS, Burnett County. • The Owner agrees to have the At-Risk POWTS monitored to detect early signs of failure on a twelve month,or less,basis, in accordance with the management plan approved under the above referenced State Plan Transaction Number and the Sanitary Permit subsequently issued by the governmental unit, Burnett County. • The owner,or owner's agent,agrees to submit the required inspection reports to the governmental unit, Burnett County,within 30 calendar days of the date of the inspection in accordance with SPS 383.55(20). • This agreement will remain in effect until the owner or service provider terminates this contract. In the event of a change in this contract,the owner agrees to file a copy of any changes,or a copy of a new service contract,with the governmental unit,Burnett County,within ten(10)days of the date of the change,or execution of the new service contract. Owner(s)Name(s)(print) Owner's Signature( ) David G. Ries Service Provider's Name(s) Service Provider's Signature Service Provider(s)Credential Number: i;t 4Y