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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 /> James or Mary Toll <br /> Mailing Address: R�,r�Pa�• <br /> 306 E Willow Creek Dr _4,6 0c.t.. <br /> Amarillo,TX 79108 r" <br /> Property Address: <br /> 23705 Bashaw Trl <br /> Shell Lake,WI 54871 <br /> Location <br /> 1/4, 1/4, S 18 ,T 38 N, R 14 W <br /> Town Of: <br /> Dewey <br /> Parcel Identification Number: <br /> 07-008-2-38-14-18-5 05-007-012000 <br /> Legal Description: <br /> See Attachement <br /> Tax ID: <br /> 3293 <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 /> I des 14 in/ <br /> (YLar� 1- T-o 1 I 9'` 9 - 2C7Z`{ <br /> Own Signature: Not Public: 30\i‘vons s <br /> 4/it--e <br /> ........ JOHNNY GIBS'N <br /> (�-p-�- �► - f Texas < <br /> y commission expires o6 €.* �llw Notary f'ubttc,S • t <br /> • '� Notary ID#13374.27-4 <br /> _2_2� �'= _ ...• •.. - 66 1 2-2026 <br /> Drafted By: Burnett Con Land Services Department Da :• <br /> Personal information you provide may ed for secondary purposes.[Privacy Law,s.1504(1)(m)] <br />