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2007/05/25 - LAND USE - LUP - Other
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18669
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2007/05/25 - LAND USE - LUP - Other
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Last modified
3/6/2020 9:03:38 AM
Creation date
10/3/2017 1:18:42 PM
Metadata
Fields
Template:
Property Files v2
Document Date
5/25/2007
Document Type 1
LAND USE
Document Type 2
LUP
Document Type 3
Other
Tax ID
18669
Pin Number
07-028-2-40-14-28-3 04-000-012000
Legacy Pin
028412802310
Municipality
TOWN OF SCOTT
Owner Name
ROBERT J & JUDY M DERRICK LIVING TRUST DTD MAY 14 2010 RICHARD L & JOAN M DERRICK LIVING TRUST DTD JUNE 15 2010
Property Address
27609 COUNTY RD H
City
WEBSTER
State
WI
Zip
54893
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FLOWS AND LOADS <br /> AFFIgAVIT <br /> 39 191 <br /> Legal Description: <br /> /L 7 ' Of S F -51 8UR COUNTY <br /> 2 7 go/J � ! L� � WIXONSIN <br /> RECENED RECORDED <br /> Parcel ID#: O 1.4r- <br /> l12 —OZ'3/ �ox�nship: � <br /> PropertyOwner: .90 ti44afl�r�� FR 1 3 2007 <br /> T 1APR APR M. <br /> Mailing Address: /.3/0 N UAJ 61 <br /> City,state,Zip: (V%it) f r-L ms/h V-r .. 4-7n1-7 G <br /> I (we) do hereby acknowledge that the use of the existing private onsite wastev Fater treatment <br /> system (POWTS), as installed on the above described real estate is based on I he following <br /> flows and loads: <br /> 300 gallons per day <br /> 220 mg/L BODS 150 mg/L TSS 30 mg/L FOG (monthly a rage of each) <br /> Furthermore, I (we) acknowledge that the modification to the structure served the existing <br /> POWTS will not result in a change that affects the wastewater flow or wastewal er contaminant <br /> load beyond the maximum capabilities of the existing POWTS and the followinc flows and loads <br /> shall not be exceeded: <br /> 300 gallons per day 4 persons (maximum occupancy for structure) <br /> 220 mg/L BODS 150 mg/L TSS 30 mg/L FOG (monthly av8rage of each) <br /> I (we) hereby state that should the flows or loads increase beyond those indical ad, the POWTS <br /> shall be modified to conform to all applicable rules. I (we) also state that should the existing <br /> POWTS show any signs of failure in any component of the POWTS, said POW rs shall be <br /> repaired or replaced according to applicable rules. <br /> O er Name(Print) Subscribed and swom to before me on this date: <br /> am <br /> N rized Owner Signatige Notary Si ature <br /> y commission expires: <br /> T , <br /> Drafted By Burnett County Zoning Office <br />
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