2016/01/12 - SANITARY - SAN - Other (3)

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POWTS SERVICING AGREEMENT I III IIII I VIII IIIIIIII I I For At-Risk Wastewater Producing Facilities per DSPS HSW Policy 8 0 2 3 8 3 0 Tx:4014741 438713 Agreement Date Plan Transaction Number BURNETT COUNTY WISCONSIN RECORDED ON: November 8,2015 Mk 01/12/2016 10:52 AM PAGES: 1 Property Owner: David GRies JEANINE CHELL REGISTER OF DEEDS Legal Description of Property REC FEE:30.00 TRANSFER FEE:0.00 SI/2—SEI/4-NE1/4 Lying East of the railroad rightofway FEE EXEMPT# Sec.20 T40N-Rl6W Township of Oakland in Burnett County Parcel ID#07-020-2-40-16-20-104-000-014000 Return to Burnett County Zoning Administration As an inducement to the County of Burnett to issue a sanitary permit for a Private Onsite Wastewater Treatment System considered being At-Risk pursuant to the Department of Safety and Professional Services (formerly Department of Commerce) High Strength Wastewater Policy of April 1,2009,the property owner agrees to do the following: 1. The owner agrees to conform to all applicable requirements of Chapter SPS 383, Wisconsin Administrative Code, relating to the maintenance requirements for the proposed POWTS. 2. Under the Department of Safety and Professional Services(formerly Commerce)HSW Policy,At-Risk POWTS are required to be monitored to detect early signs of failure. The management plan shall provide for inspections and evaluation of the performance of this system on a twelve month,or less,basis by a person qualified to conduct them; in addition,a Service Contract as per SPS 383.52(l)(c)is required to be executed. 3. The owner or the 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). 4. In the event that this soil absorption system,or any of its component parts,malfunctions in any way,the owner must follow the contingency plan described in the approved plans for the design and operation of this POWTS. 5. This agreement will remain in effect only until the governmental unit responsible for the regulation of POWTS certifies that the property is no longer served by the system. In addition, this agreement may be canceled by executing and recording said certification with reference to this agreement in such a manner that will permit the existence of the certification to be determined by reference to the property. 6. This agreement shall be binding upon the owner, the heirs of the owner, and assignees of the owner. The owner shall submit this agreement to the Register of Deeds in a manner that will permit the existence of the agreement to be determined by reference to the property where the At-Risk Private Onsite Wastewater Treatment System is installed. Owner Name(s)(print) Subscribed and sworn to before me this date: David G Ries ill 12 12-C)15 No Owners) S' 7, KATIE SMITH My commission expires: Notary Public State of Wisconsi (' 115 Ila, Drafted by: Burnett County Zoning