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. P 1111111 11111111111111 <br /> PRIVATE ONSITE WASTEWATER TREATMENT si x:8 815 n <br /> SYSTEM COVENANT: UNDERSIZED SYSTEM <br /> "Bedroom Addition" KRISTI CHLESOWSKI <br /> DANE COUNTY <br /> REGISTER OF DEEDS <br /> This covenant is between DOCUMENT # <br /> Lcurt 5330926 <br /> `,N - re. 06/05/2017 3:43 PM <br /> grantors,and the County of Dane, regarding the private onsite wastewater Trans. Fee: <br /> treatment system(POWTS)on the following described parcel(s)located in the Exempt#: <br /> Town of f∎kt ii t re)'5"\ Rec. Fee:30.00 <br /> Pages: i <br /> A <br /> in the P V tAt of the '�'1 of Section I 3 ,T I S N,R b E. <br /> Record this document with the Register of Deeds <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 /> Your name and return address <br /> Cee L ?A <br /> 7e1,4 co...4111(/ eld A <br /> Vii-G filet tkkr 5 93 <br /> Tax Parcel# o'1 o/o5c 7 'i b2 11 -4 <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 wi ,e state a count codes in force at that time. This is binding on all future heirs,owners and assigns. <br /> - ACKNOWLEDGEMENT <br /> Owne a Owner Name(Signature) <br /> r" r el 3 L--cti"' �l <br /> Owner Name(Print) J t Owner Name(Print) <br /> STATE OF WISCONSIN ) <br /> ) ss. <br /> COUNTY OF DANE ) <br /> Personally came before me this day of ,.J LAJ\.Q._ J.°'2o11,the above named person(s) <br /> to me known to be the persons who executed the foregoing instrument and acknowledged the same. <br /> \ , c' C.1bbS ( l'�aC-MGAbbS <br /> Notary Public Dane�ty,Wisconsin <br /> My Commission is permanent. (If not,expiration date is ti 1 I j 2,C)) <br /> Public Health Madison Dane County EH 4/14 <br /> ,p--L174e / 14.E .1:;- r 7 L el a <br /> 1 <br />