2016/10/12 - SANITARY - SAN - Other

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Wisconsin Department of industry, HOLDING TANK AGREEMENT 1HN/� 5iun Labor and Human Relations water Systems 3133. 4 Document No./Plan Identification No. This agreement is made between the This space ref'9,ry491MMordmg data governmental unit and holding tank 442495 Agreement Date owner(s) ) 0-7- 10 BURNETT COUNTY WISCONSIN RECORDED ON: County or Local Governmental Unit Holdm Tank Owners) 10/12/2016 9:43 AM &A(/✓Cdff �OtAAI -fy �r Vey �SO11� PAGES: 1 (called M ni,i:l below 7EANINE CHELL We acknowledge that application is being made for the installation of(a)holding REGISTER OF DEEDS nks)on the followingproperty: RNC FEE:FEE: tail p p y: (Provide legal land description) TRANSFER FEE:0.00 P-4 P-W K6� J lo EXEMPT ft 7 3 pjq t-31(l (cyy Return To ------------------------ Burnam C'o zz'rl I or that continued use of the existing premises requires that a holding tank be installed on the property for the purpose of proper contamment of sewage. Also,the property cannot now be served by a municipal sewer,or any other type of private sewage system as permitted under Ch ILHR 83,Wis Adm. Code,or Ch 145,Stats /� /^1 As an inducement to the County of 7J4�✓Yt-/ / to issue a sanitary permit for the above described property.we agree to do the following: 1. Owner agrees to conform to all applicable requirements of Ch. ILHR 83,Wis. Adm Code relating to holding tanks. If the owner fads to have the holding tank properly serviced in response to orders issued by the municipality to prevent or abate a human health hazard as described in s. 254.59. Stats.,the municipality may enter upon the property and service the tank or cause to have the tank to be serviced and charge the owner by placing the charges on the tax bill as a special assessment for current services rendered The charges will be assessed as prescribed by s.66 60,Stats. 2 The owner agrees, pursuant to s.ILHR 83 18(10),Wis Adm Code,to have installed in anew building or new structure a water meter approved by the County and State The water meter shall be installed by a plumber authorized by the State to conduct such installations,with said installation complying with State regulations and manufacturers specifications The owner agrees to be financially responsible for the purchase, installation, maintenance,and repair of the water meter,and agrees to allow the municipality to enter the above described property on a regular basis to read and/or inspect the water meter 3. Owner agrees to pay all charges and cost incurred by the municipality for inspection,pumping,hauling,or otherwise servicing and maintaining the holding tank in such a manner as to prevent or abate any human health hazard caused by the holding tank The municipality shall notify the owner of any costs which shall be paid by the owner within thirty(30)days from the date of nonce In the event the owner does not pay the costs within thirty(30)days,the owner specifically agrees that all the costs and charges may be placed on the tax roll as a special assessment for the abatement of a human health hazard,and the tax shall be collected as provided by law 4. The owner,except as provided by s. 146.20(3)(d),Stats.,agrees to contract with a person who is licensed under Ch.NR 113,Wis.Adm Code,to have the holding tank serviced and to file a copy of the contract or the owner's registration with the municipal,ty. The owner further agrees to file a copy of any changes to the service contract,or a copy of a new service contract, with the municipality within ten (10) business days from the date of change to the service contract 5. The owner agrees to contract with a person licensed under Ch NR 113,Wis Adm.Code,who shall submit to the municipality on a semiannual basis a report in accordance with s ILHR 83 18 (4)(a)2,Wis Adm.Code,for the servicing of the holding tank. In the case of registration under s 146.20(3) (d),Stats.,the owner shall submit the report to the municipality.. The municipality may enter upon the property to investigate the condition of the holding tank when pumping reports and meter readings may indicate that the holding tank is not being properly maintained. 6. This agreement will remain in effect only until the local governmental unit responsible for the regulation of private sewage systems certifies that the property is served by either a municipal sewer or a soil absorption system that complies with Ch ILHR 83, Wis Adm. Code- in addition, this agreement may be cancelled by executing and recording said certification with reference to this agreement in such manner which will permit the existence of the certification to be determined by reference to the property 7. This agreement shall be binding upon the owner,the heirs of the owner,and assignees of the owner The owner shall submit the agreement to the register of deeds,and the agreement shall be recorded by the register of deeds in a manner which will permit the existence of the agreement to be determined by reference tothe property where the holding tank Is installed. Owner(s)Name(s)-Print Notri )s (5) 6741 Pea✓1-4-n5O f7 /before-meonthisdate: Li W Notary Public ahkoft My JENNIFER L LUTGEN N-01ARY .' a' NJNNESOTA Thu jolormatwn yuu provide may be used by other government agency programs 1Privacy Law,5. 15.04(1)(m "IT, " ley Giiinils3im Expires Jail.UBLIG 1,c SAO-61121(R.04194)