Laserfiche WebLink
PRIVY INSTALLATION AGREEMENT—COPY TO BE ATTACHED TO THE SANITARY PERMIT APPLICATION <br /> Property Owner(s): D Reserved For Recording Date <br /> Mailing Address: <br /> mle_- e , �/ u. 346348 <br /> Location: <br /> 1141 1/4 S , T LIV N, R !w E o BURNIM OUNTY <br /> City,Villag ownship f: <br /> I� <br /> Parcel Tax Number: RECENED AND RECORDED <br /> D - r;- D -3oD APR 1 6 YDS <br /> Legal Description: Lo 4- <br /> )3 1_0h9- �Ic,7cfNf) lGd . T 11:45 A.M. <br /> YA"i MUDU <br /> Porsontl information you provide may be used for secondary puposea.IPMaq Law,a.15.04(1)(m)] -�-{- <br /> 1. No plumbing will installed in the privy. <br /> 2. No plumbing will be installed in the premises served by the privy unless a code compliant soil absorption system or <br /> holding tank exists, or a valid sanitary permit to install such a system has been issued. <br /> 3. A privy vault/pit shall maintain minimum setbacks as specified in Table 1. <br /> Table 1 Well Well Lake/Stream Additional County Setbacks <br /> Open Pit 50 Ft 25 Ft Min. 75 Ft <br /> Sealed Vault 25 Ft 25 Ft Min. 75 Ft C25 ( -�o <br /> 4. Privies for public buildings shall comply with )LHR 52.63, Wis. Adm. Code. <br /> 5. Privies used for one-and-two-family purposes shall be constructed in such a manner so as to exclude flies, rats and <br /> other vermin. Doors should be self-closing and vault ventilators should terminate at least one foot above the roof. <br /> 6. A privy vault shall be constructed of watertight plastic, fiberglass, coated steel or monolithic concrete. Materials shall <br /> comply the intent with Comm 83.20, Wis. Adm. Code. Counties may by ordinance, establish minimum sealed vault <br /> sizes and type or construction within the guidelines of Comm 83.20, Wis.Adm. Code. <br /> 7. The privy shall be kept clean and sanitary. The contents of the pit or vault shall be disposed in accordance with NR <br /> 113, Wis. Adm. Code. <br /> 8. This agreement shall be binding on the owner, their heirs and assignees. This documentation shall be recorded by <br /> the register of deeds in a manner which allows its existence to be determined by reference to the property where the <br /> privy is installed. <br /> Printed Owner(s) Name(s): <br /> 4 ' ' t/ S Subscribed and sworn to before me on this dater <br /> Owner(s)Signature: <br /> Notary PublicLl <br /> My commission commission expires on: <br /> SBD-6432(R.7/98) <br />