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BURNETT COUNTY ZONING ADMINISTRATION <br /> BURNETT COUNTY GOVERNMENT CENTER <br /> 7410 COUNTY ROAD K,#120 <br /> (715)SIREN,349-21090NSIN 54872 PO)?�tre� <br /> 0/Vi i INCE <br /> RELEASE OF HOLDING TANK <br /> AGREEMENT <br /> The Burnett County Zoning Office hereby certifies that <br /> the Holding Tank Agreement Form signed by (property <br /> owner): Gerald X. Helmin, is no longer required for <br /> this property. No (POWTS) private onsite waste <br /> treatment system (permit # 23 76 0 ) was ever <br /> installed on this parcel. Return to: Burnett County Land Services <br /> 7410 County Road K,#120 <br /> Siren,WI 54872 <br /> Recorded in the office of the Register of Deeds, Burnett <br /> County, Wisconsin, as: <br /> Document No. 330035 Volume 646 Page 498 <br /> Legal Description of Property: Lot 19, Clam Lake Pines(Section 26-39N-R16W) <br /> N/K/A Lot 19 CSM#5013 Vol 28 Pg 139 Document#466673 <br /> Parcel Number: 07-018-2-39-16-26-5 15-093-029000 <br /> Dated: //Z5- <br /> By: <br /> Z5-By: A Print name: -°7; S©N 7;1-ALT <br /> ( rnett County Zoning Office) <br /> Title: L-gtn Dtv�L7`��^ <br /> STATE OF WISCONSIN <br /> COUNTY OF BURNETT <br /> This instrument was acknowledged before me <br /> cPs, avoi <br /> ane. <br /> Notary Public <br /> My Commission Expires: '2[424. / O <br /> This instrument was drafted by: <br /> The Burnett County Zoning Office <br /> Siren,Wisconsin 54872 <br /> ANN SCHAEFER <br /> Y Public-State d LAh1s <br /> Wisconsin <br />