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• <br /> UNOFFICIAL COPY <br /> Il IIIIIIIIIIIIIIIIIII <br /> PRIVATE ONSITE WASTEWATER TREATMENT 9 1 4 5 2 5 8 <br /> SYSTEM COVENANT: UNDERSIZED SYSTEM Tx:8853047 <br /> "Bedroom Addition" KRISTI CHLEBOWSKI <br /> DANE COUNTY <br /> REGISTER OF DEEDS <br /> This covenant is between <br /> DOCUMENT # <br /> ishifRitzier/ 1004 r j' To W wt icte,qa,r 5326246 <br /> granto ,and the County of Dane,regarding"the private onsite wastewater 05/17/2017 11:08 AM <br /> treatment system(POW )on the following described parcel(s)located in the Trans. Fee: <br /> Ti <br /> Town of RI t l4/l Exempt#: <br /> ' Rec. Fee: 30.00 <br /> in the of the of Section ,T N,R E. Pages: 1 <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 /> l_ot-tWO (?) Co rtlif,4 S.r 14111 No. 8833 17ror Your name and return address <br /> P k V,lvioe II of (erh*d Su •'l t`Om . Tatel aim. KI0;se r <br /> W tYrow;&t, Pal` tk'o1� e S jtosvot. No. 67i/65/Tou.'t 3`l yo Oil C-1 AP <br /> of- RAJ, D ite Covviiy, Lvts 0,14; S�0tiiviA, wt 5358 <br /> • <br /> Tax Parcel#00 10160- Ss( 1 7c81 <br /> I(We)the undersigned are adding a bedroom. <br /> In compliance with the requirements of Dane County Code ch.46,or acts amendatory thereto,this affidavit is to <br /> acknowledge that the existing septic tank is not sized in accordance with the current regulations for the waste water load <br /> generated by the building served.The existing soil absorption component is located in soil that is suitable for the below <br /> grade absorption area,but it is not sized in accordance with the current regulations for the wastewater load generated by the <br /> building served. This is also to acknowledge that there is/is not an approved area for the purposes of siting a replacement <br /> absorption area on this parcel. <br /> If/when the existing soil absorption area is determined to be failing as defined in s. 145.245 Stats,I(We)will replace it in <br /> accordance with the state and county codes in force at that time. This is binding on all future heirs,owners and assigns. <br /> ACKNOWLEDGEMENT r <br /> N-I TO MM(f,'('- <br /> Owner Name(Signature) Owner Name(Signature) <br /> Mhtty M (3ut7—ler / Kiei 6or -11701A Itt& k.ltibgr <br /> Owner Name(Print) Owner Name(Print) <br /> STATE OF WISCONSIN ) <br /> ) ss. <br /> COUNTY OF DANE ) <br /> Personally came before me this l(P day of rn 8y * 2017 ,the above named person(s) <br /> to me known to be the persons who executed the foregoing' strumcnt and ackrfow -dge/the same. <br /> ,i <br /> Todd hi l<41. ,r <br /> Not Publ c Dane r oun isconsin <br /> My ommission is p anent. (If not,expiration date is 3-8-AN? <br /> Public Health Madison Dane County EH 4.14 <br /> \ <br />