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2004/04/30 - LAND USE - LUP - Other
Burnett-County
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TOWN OF SCOTT
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17770
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2004/04/30 - LAND USE - LUP - Other
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Last modified
3/6/2020 7:56:31 AM
Creation date
10/4/2017 1:06:07 PM
Metadata
Fields
Template:
Property Files v2
Document Date
4/30/2004
Document Type 1
LAND USE
Document Type 2
LUP
Document Type 3
Other
Tax ID
17770
Pin Number
07-028-2-40-14-08-5 05-006-018000
Legacy Pin
028410802000
Municipality
TOWN OF SCOTT
Owner Name
MICHAEL A JOHNSON
Property Address
29140 LONG LAKE RD
City
DANBURY
State
WI
Zip
54830
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FLOWS AND LOADS 366091 <br /> AFFIDAVIT <br /> Legal Description: BUR*""COUNTY <br /> See Attached ONSIN <br /> RSCEtVEOAORpEp <br /> Parcel ID#: 028-4108-02-000 Township: Scott APR 3 0 2i <br /> Property Owner:Michael and Tr.icy Johnson <br /> T 2:00 P.M. <br /> Mailing Address: 2318 Hidden alley Lane <br /> City,State,Zip: Stillwater, MN 55082 S R <br /> RE EEDS <br /> I (we) do hereby acknowledge that the use of the existing private onsite wastewater treatment <br /> system (POWTS), as installed on the above described real estate is based on the following <br /> flows and loads: <br /> 150 gallons per day <br /> 220 mg/L BODS 150 mg/L TSS 30 mg/L FOG (monthly average of each) <br /> Furthermore, I (we) acknowledge that the modification to the structure served by the existing <br /> POWTS will not result in a change that affects the wastewater flow or wastewater contaminant <br /> load beyond the maximum capabilities of the existing POWTS and the following flows and loads <br /> shall not be exceeded: <br /> 150 gallons per day 2 persons (maximum occupancy for structure) <br /> 220 mg/L BODS 150 mg/L TSS 30 mg/L FOG (monthly average of each) <br /> I (we) hereby state that should the flows or loads increase beyond those indicated, 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 POWTS shall be <br /> repaired or replaced according to applicable rules. <br /> Owner Name(Print) Subscribed and sworn to beff re me on this date <br /> MAl 041 • as aD � <br /> No�tarj��Owne ign r f�Y---N[otary Syna re <br /> YAW- <br /> my is <br /> mmslon a Ire . <br /> � -3/—aooS <br /> Drafted By Burnett County Zoning Office IQ <br /> PEGGY A.JOHNSON <br /> NOTARY PUBIJC#UNNESOTA <br /> MY COMMISSION EXPIFES 1-MaM <br />
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