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8034971 <br /> Tx:4020967 <br /> FLOWS AND LOADS 444581 <br /> AFFIDAVIT <br /> BURNETT COUNTY WISCONSIN <br /> RECORDED ON: <br /> Legal Description: Lot 13 of CSM V5 P191 (#204054) Map il106 2- 03/06/2017 9:16 AM <br /> PAGES: 1 <br /> Parcel ID#: 07-012-2-40-15-28-5 05-001-015000 Township: Jackson JEANINE CHELL <br /> REGISTER OF DEEDS <br /> Property Owner: James&Marette Jorgenson REC FEE:30.00 <br /> TRANSFER FEE:0.00 <br /> Mailing Address: 27832 625""St FEE EXEMPT* <br /> City,State,Zip: Kasson, MN 55944 Return to: Burnett County Zoning <br /> I (we) do hereby acknowledge that the use of the existing private onsite wastewater treatment system (POWTS), <br /> as installed on the above described real estate is based on the following 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 POWTS will not <br /> result in a change that affects the wastewater flow or wastewater contaminant load beyond the maximum <br /> capabilities of the existing POWTS and the following flows and loads 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 shall be <br /> modified to conform to all applicable rules. I (we)also state that should the existing POWTS show any signs of <br /> failure in any component of the POWTS, said POWTS shall be repaired or replaced according to applicable <br /> rules. <br /> Owner Name(Primo Subscribed and swom to before me on this date: <br /> MARe <br /> N razed Owner Signature NotarySignature Ra1G` U6 <br /> � u �n <br /> y commission expires: <br /> Cl <br /> {Yla ak <br /> ao/7 <br /> Drafted By Burnett County Zoning Office <br />