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2019/01/21 - SANITARY - SAN - Repl HT - SAN-18-107
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2019/01/21 - SANITARY - SAN - Repl HT - SAN-18-107
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Last modified
3/6/2020 2:25:17 PM
Creation date
1/21/2019 1:50:28 PM
Metadata
Fields
Template:
Property Files v2
Document Date
1/21/2019
Document Type 1
SANITARY
Document Type 2
SAN
Document Type 3
Repl HT
County Permit Number
SAN-18-107
State Permit Number
609305
Tax ID
34414
Pin Number
07-032-2-41-16-33-5 05-003-022100
Municipality
TOWN OF SWISS
Owner Name
ROSS D & SHELLY L STARK
Property Address
7589 ROUND LAKE DR
City
DANBURY
State
WI
Zip
54830
Previous Owners
ROSS D & SHELLY L STARK
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HOLDING TANK SERVICING CONTRACT <br />Contract Date: ; j i 2, ) <br />This contract is made between the Holding Tank Owner and the Pumper. <br />Holding Tank Owner(s) Name(s): Pumper's Name: <br />Ross D. ,> sH y t-, sTA9K s v� �'.LkrTI <br />We acknowledge the installation of (a) holding tank(s) on the following property (Provide legal <br />description and computer number): RlG►J T04f✓N Si�Jt� <br />CSnA� Vz6� P3zg, 4oVT. LOT 3S 33, T YJ Al, / <br />F3t�.Riu�-rT roccN7}�, w�xoNs1A1 <br />1. The owner agrees to file a copy of this contract with the County of Burnett, as required under WI <br />Code SPS 383.21(2)5. <br />2. The owner agrees to have the -holding tank(s) serviced-ty the pumper and guarantees to permit the <br />pumper to have access and to enter upon the property for the purpose of servicing the holding tank(s). <br />The owner agrees to maintain the all-weather access road or drive so that the pumper can service the <br />holding tank(s) with the pumping equipment. The owner further agrees to pay the pumper for a <br />charges incurred in servicing the holding tank(s) as mutually agreed upon by the owner and pumper. <br />3. The pumper agrees to submit to the County, reports for the servicing of the holding tank(s) in manner <br />specified by the County. The pumper further agrees to include the following in the report: <br />a. The name and address of the person responsible for servicing the holding tank; <br />b. The name of the owner of the holding tank; <br />c. The location of the property on which the holding tank is installed; <br />d. The sanitary permit number issued for the holding tank; <br />e. The dates on which the holding tank was serviced; <br />f. The volumes in gallons of the contents pumped from the holding tank for each servicing; <br />g. The disposal sites to which the contents from the holding tank were delivered. <br />h. Condition of holding tank and components at time of inspection. <br />4. This agreement will remain in effect until the owner or pumper terminates this contract. In the event <br />of a change in this contract, the owner agrees to file a copy of any changes to this service contract or a <br />copy of a new service contract with the municipality and the County named above within ten (10) <br />business days from the date of change to this service contract. <br />Owner(s) Names(s) (Print) <br />Owner's ignature <br />oss <br />livilcl +Far <br />Pumper's N me (Print) <br />umper' ig a re <br />Pumper's Re ' ton Number <br />
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