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YK1 VA I L1. JL" wjsj.r .i 1 L'!vl LA-, 'V VIII I 1 , . <br /> POWTS MA)NTI;NANCL FREQUENCY <br /> ENCY <br /> This covenant is between h0 mss 1Db K t ::. <br /> Print name of property owner „',• : G <br /> And the County of Dane regardingthe private onsite wastewater treatment system <br /> on land located in the Town of es,S•\-0 I <br /> in the _r!y_sEquarler of Section ZZ ,'1' �JN, R (/ <br /> 7)'pe or neatly print the legal description of your properly in the space below, <br /> The legal description is found on your deed and usually on your lax bill. If you <br /> nc•c'd more space, 11Se the revere side or utlat:h a copy of the deed.) <br /> Lok C,Sm 39 3(4, <br /> /record Ws doormen,wills the/?'l;/Sher of Deeelr <br /> Your teak and return address <br /> Thomas J 130be.{C <br /> B US' Hawks;Iav'a.n '1"r <br /> txForc_5 , w( SSS32- <br /> • <br /> Tax Parcel fl 09I 1'z.Z44^ 11510 - U <br /> As owner(s)of this property I (we)acknowledge that the private onsite wastewater treatment system(POWTS)bola; <br /> installed on this property has a design that includes components other than au outlet filter that require maintenance/servicing <br /> more often than onee every three years, The component(s)and servicing frequency are <br /> Compongnt: Type of Maintenance/Servicing: I egpired Fregilencv: <br /> W " I14 fCc.`r'i 0f1 /G MGr1��$ <br /> ` - bD .7 asp eGW (p in on <br /> („§)s s o ,N0�151_.P 4T REPLACEMENT fr:0/0±-In addition to these components there is/are treatment or dosing tank components that require inspection ut least once eva•ry <br /> three years and servicing whenever the solids(sludge and scans)accumulate to more than 1/3 of the liquid capacity of Ih•. <br /> lank. 1Visconsin Administrative Codes Conlin 83.54(4)also requires a visual inspection of the soil absorption cell once <br /> every duee years to assure that partially treated or untreated sewage effluent is not discharging to the ground Sur face. <br /> Any new owner(s),heirs)or assign(s)ol'this property will be given a copy of the design rind maintenance plan for the <br /> POWTS that was prepared in compliance with Wisconsin Administtalive Code eh Comm 83 and Dane County Code eh'tb <br /> at the time of title transfer by the owner of record. <br /> ACI(NOWLEDGF:MENU' <br /> S Tq �q�l <br /> Owner Name(Signature) .� 0741'61' to(Signcturc) --� <br /> r f 1'. t. AR <br /> ownc N:une(Pon) <br /> - - - <br /> Owner •* •(Trial) ---- - <br /> S•I'ATL or WISCONSIN ) , ,• ,•� :°° <br /> )COUNTY OP I)ANP. ss. `.(Jr <br /> •Personally carne before me this_ (-C day of y e _• Flt 20■5" ,the above named pason(s) <br /> to me known to he the persons who ever t1cd 111e foregoing instalment and acknowledged the came. <br /> Notary Public Dane :ounly,Wisconsin <br /> \Y <br /> My Commission ispcnmutent. (11'1101,espiralion date is, /1-2-,29a) <br /> t)anc County I nviror.mentol I tcalth Shul <br />