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• !1 l.C.;t:.: 'j l.: �...• cif • <br /> OFF-LOT PRIVATE ONSITE WASTEWATER REGIS-11:1; �� ► <br /> 1' h - ) <br /> TREATMENT SYSTEM EASEMENT DA�` �'''!'? Y \, I <br /> 2014 JUN -5 PH I: 58 <br /> This indenture made by Town of Bristol as grantor,hereby creates an easement <br /> over the following described parcel(s)of real estate located in the Town ofBristol, <br /> in the NW%of the SW i/4 of Section 30;T9N,RI III,hereinafter referred to as <br /> Parcel I. <br /> Type or neatly print the legal description of your property In the space below.If <br /> you need more space,use the reverse side or attach a copy of the deed <br /> East 22 feet of the West 30 feet of Lot 29,Bristol Gardens,Dane County, <br /> Wisconsin <br /> Record this document with the Register of Deeds <br /> • Your name and return address <br /> The adjacent parcel described as parcel#012/0911.303-2049-0,as shown on Don Tierney <br /> Exhibit A is hereinafter referred to as Parcel U. The POWTS easement over 3584 Egre Rd <br /> Parcel I shall be in conformity with Exhibit A,or revisions thereto that may be DeForest,WI 53532 <br /> necessary to construct said POWTS. Components of the POWTS serving the <br /> building on Parcel II that are located on Parcel I shall be properly maintained at Tax Parcel No:012/0911-303-2049-0 <br /> •the expense of the owner(s)of Parcel U. No construction shall be permitted on <br /> Parcel I or Parcel II that will interfere with the installation,maintenance or <br /> operation of the POWTS or with an approved replacement system area as shown <br /> on exhibit A. <br /> This easement shall provide access to all areas of Parcel I necessary to achieve the installation,connection,inspection,mantenance, <br /> repair or replacement of any or all of the POWTS components exclusively for the building shown on exhibit A. Authorized access is <br /> granted to the system owner,the owner's agents,and representatives of the Dane County Environmental Health Section,excluietely <br /> for the stated purposes. <br /> This easement is granted expressly as required by chapter 46 of the Dane County Code of Ordinances to obtain the approval ofa <br /> POWTS system serving a building not located on the same parcel with the POWTS. <br /> This easement shall run with the land and Anil be binding upon the owner(s)of the described parcel(s)and his,her or their heirs, <br /> successors or assigns. <br /> �/f ACKNOWLEDGEMENT <br /> Owner Name( it e)� �. <br /> Donald C.Tierney <br /> OwnerName(Signature) • :ristol,Clerk(Si e) <br /> Joanne K.Tierney Sandra Mister <br /> STATE OF WISCONSIN ) • <br /> ) ss. <br /> COUNTY OP DANE <br /> Personally came before me this s day of 71J n(e- 201i, , ve .- to own to be the person(s)who exacted <br /> the foregoing instrument and acknowledged the same. <br /> Notary c <br /> 074"Co,, ' sin -S��ICs <br /> My Commission is permanent. (if not,expiration date is j_-pr 13, Z./8 ) <br /> Drafted by:Dane County Environmental Health 5/01 <br /> pale <br />