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BURNETT COUNTY ZONING ADMINISTRATION <br /> BURNETT COUNTY GOVERNMENT CENTER <br /> 7410 County Road K, #102 Phone(715) 349-2138 <br /> Siren, Wisconsin 54872 <br /> November 15,2002 <br /> Debra Mitchell <br /> 25461 State Road 35 <br /> Webster,WI 54893 <br /> Dear Ms. Mitchell: <br /> In reviewing the permit information for the replacement of your existing sanitary system it <br /> appears that you may qualify for the Wisconsin Fund Grant Program. <br /> Once program participation has been determined please complete the enclosed Wisconsin Fund <br /> Owner's Application(front page only). <br /> Return the Owner's Application along with copies of: <br /> ♦ Your 2001 Federal Income Tax Form <br /> (If you did not file Income Tax,please contact this office) <br /> ♦ Cost of sewer installation <br /> ♦ Signed Maintenance Agreement <br /> ♦ Copy of your Deed for your property <br /> Also enclosed is an Order for Correction. This is your copy to keep. This form indicates the type <br /> of system failure and a timeframe for which it should be corrected. <br /> There will be an application fee of$100 or 10%of the check to cover the county costs,but only if <br /> you receive this grant money. <br /> Please return this information at your earliest convenience. Contact our office if you should have <br /> any further questions. Thank you. <br /> Sincerely, <br /> 4 641 <br /> Keith Stoner <br /> Assistant Zoning Administrator <br /> KS:mb <br /> Enc. <br />