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BURNETT COUNTY ZONING ADMINISTRATION <br /> BURNETT COUNTY GOVERNMENT CENTER,ROOM 130 <br /> 7410 County Road K,#102;Siren,Wisconsin 54872 Phone(715)349-2138 <br /> Private Onsite Waste Treatment System <br /> MAINTENANCE AGREEMENT <br /> Owner. l J ti l W S►4 �I l C G li >t <br /> Mailing Address: 2yOS O w, Si-f- 111,ec4i Lti, <br /> — S " l 1 t..4 lc, ) L-JS-4 871 - 9/c <br /> Phone: 7/ S <br /> Legal Description of Property: S - 10 i-38 f ) 4(.J <br /> 003 - alto --02 - Goa <br /> Site Address: S" w 1 a b0 ✓r <br /> Maintenance of your (POWTS) sanitary system is important, in that proper maintenance will ensure its <br /> efficiency and extend the life of the system. Improper use and poor maintenance of your sanitary system <br /> could result in the premature failure of your system and lead to costly repairs. <br /> Comm. 83.54 requires that all(POWTS) sanitary systems be inspected at least once every three years, or <br /> at a frequency outlined in the specific management plan. Note: The System Management Plan may <br /> require additional inspections than required for certification below. <br /> Burnett County residents may be eligible to receive some cost sharing funding for the replacement of <br /> failing systems whereby such systems were in operation prior to July 1, 1978 meeting specific criteria. <br /> The property owner agrees to submit to the County a Certification Form (to be provided by the County) <br /> every three years signed by a Master Plumber, Master Plumber Restricted, WI POWTS Inspector, WI <br /> POWTS Maintainer, or a Licensed Septage Hauler. The form shall require certification of the following: <br /> A. That after inspection or pumping an aerobic treatment tank is less than 1/3 full of sludge <br /> and scum, and a pump chamber component, if applicable, is inspected as directed by the <br /> plumber's management plan. <br /> B. And that the dispersal component has been inspected to determine whether wastewater or <br /> effluent is ponding on the surface of the ground. <br /> I, the undersigned, have read the above requirements and I agree to maintain the private sewage disposal <br /> system in accordance with the management plan for the specific system provided by the plumber, and as <br /> set by the-Wisconsin Department of Commerce and the Burnett County Sanitary Ordinance. ' <br /> Signed: t l/1f�1VC.K-4Cx*,,/rkr-1 Dated: 0 8 ��(7 <br />