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BURNETT COUNTY ZONING ADMINISTRATION <br /> BURNETT COUNTY GOVERNMENT CENTER, ROOM 130 <br /> 7410 County Road K,#102; Siren,Wisconsin 54872 Phone(715)349-2138 <br /> SEPTIC TANK MAINTENANCE AGREEMENT <br /> OWNER: <br /> ADDRESS: /gz ;ie? /9-p- <br /> 2- <br /> PHONE: C�/ toS��^ �ij �" s�1o27 C� lji�✓�/' 77�- 10��' © <br /> LEGAL DESCRIPTION OF PROPERTY: L a T 3 PL/1 r ©.P' �'fC$L' S,C�Y Ae <br /> Ga✓�-�2,JMENd iiais 1 z 3 s�cr�o�a?9 Tm�� lrP7'�o�✓�P�..r6��t�45 <br /> a.)tf" - u��`) q �% o <br /> PROPERTY ADDRESS:�7� 5 C�l£�� �/� pD• LCJKg�/F�_ l✓/ �LI�9� <br /> IMPROPER USE AND MAINTENANCE OF YOUR SEPTIC COULD RESULT IN ITS PREMATURE <br /> FAILURE TO HANDLE WASTE. PROPER USE AND MAINTENANCE SHOULD EXTEND THE <br /> LIFE OF THE SYSTEM CONSIDERABLY. PROPERTY MAINTENANCE CONSISTS OF <br /> PUMPING OUT THE SEPTIC TANK EVERY 3 YEARS OR AS NEEDED BY A LICENSED SEPTIC <br /> TANK PUMPER. WHAT YOU PUT INTO THE SYSTEM CAN AFFECT THE FUNCTION OF THE <br /> SEPTIC TANK AS A TREATMENT STAGE IN THE WASTE DISPOSAL SYSTEM. <br /> BURNETT COUNTY RESIDENTS MAY BE ELIGIBLE TO RECEIVE SOME COST SHARING <br /> FUNDING FOR THE REPLACEMENT OF FAILING SYSTEMS WHEREBY SUCH SYSTEMS <br /> WERE IN OPERATION PRIOR TO JULY 1, 1978. IN PROVIDING ANY COST SHARING, THE <br /> STATE DOES REQUIRE THAT OWNERS OF ALL NEW SYSTEMS AGREE TO KEEP THEIR <br /> SYSTEMS PROPERLY MAINTAINED. NATURALLY, THE PROPER MAINTENANCE IS <br /> BENEFICIAL TO YOU AND THE GENERAL PUBLIC. <br /> THE PROPERTY OWNER AGREES TO SUBMIT TO THE COUNTY A CERTIFICATION FORM <br /> (TO BE PROVIDED BY THE COUNTY)EVERY 3 YEARS—IF INSPECTED, SIGNED BY A <br /> MASTER PLUMBER, JOURNEYMAN PLUMBER, RESTRICTED PLUMBER OR WI POWTS <br /> INSPECTOR OR IF PUMPED,A LICENSED SEPTAGE HAULER. THE FORM SHALL REQUIRE <br /> CERTIFICATION OF ONE OF THE FOLLOWING: <br /> A. THAT AFTER INSPECTION,THE SEPTIC TANK IS LESS THAN 1/3 FULL OF <br /> SLUDGE AND SCUM AND APPEARS TO BE IN OPERATING CONDITION. <br /> B. THAT THE SEPTIC TANK ONSITE HAS BEEN PROPERLY PUMPED. <br /> I, THE UNDERSIGNED,HAVE READ THE ABOVE REQUIREMENTS AND I AGREE TO <br /> MAINTAIN THE PRIVATE SEWAGE DISPOSAL SYSTEM IN ACCORDANCE WITH THE <br /> STANDARDS SET FORTH,HEREIN,AS SET BY THE WISCONSIN DEPARTMENT OF <br /> COMMERCE AND THE BURNETT COUNTY SANITARY ORDINANCE. <br /> SIGNED: �` DATED: / ' ✓ ��'�" <br />