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FLOWS AND LOADS <br /> AFFIDAVIT 387635 <br /> Legal Description: <br /> Lof a O Srn V. 1142 • d -), Cin Go v Lo-1- a i6ec/S BURNETT COUNTY <br /> d 6 o v Lo f a �5e c 1 W) M A i. 4 9 r y WISCONSIN <br /> RECEIVED AND RECORDED <br /> ParcellD#: 60G-a4J (,-D/7-$1O Township: N4nlCIS NOV - 9 1006 <br /> Property Owner: .la5eP4,f'�Ctim�,.nnrTlm,p+h,�(11aC�0iiA�d T 2:15 P.M. <br /> Mailing Address: Q90L1 LA)t )or 1-nIS <br /> $ <br /> City, state,Zip: Woodbcc� /h&J 55/3.S <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 /> 300 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 /> 300 gallons per day 4 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) t'M Ma-r-dunaL01 Subscribeo and swum to before me on this date <br /> Notarized Owner Signature s .-,�,/� Notary Sig tura <br /> 7 y commMsion expires: <br /> i <br /> l roh 7, a of 'Y" <br /> Drafted By Burnett County Zoning Office <br />