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ill ril ltip l <br /> Ii i <br /> i' I I t i1i i1 <br /> 9150333 <br /> Tx:8856855 <br /> PRIVATE ONSITE WASTEWATER TREATMENT <br /> SYSTEM COVENANT: UNDERSIZED SYSTEM KRISTI CH EBOWSKI <br /> DANE COUNTY <br /> "Bedroom Addition" REGISTER OF DEEDS <br /> DOCUMENT # <br /> This covenant is between O I <br /> N' . fr. fr 4 53295$9• <br /> ✓ t75J31 Trans. 1:: PM <br /> //�� rans. Fee: <br /> grantors,and th/County of Dane,regarding the private onsite wastewater Exempt#: <br /> treatment system(POWTS)on the following described parcel(s)located in the Re c. Fee:30.00 <br /> Pages: 1 <br /> Town of f)i=di Li• r,, , <br /> in theA Iv 4f the$G/4of Section 2.D ,T N,R E. _, <br /> Record this document with the Register ofDeeds <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 /> r1% 1.1 TON 0 44 • e.PL To:✓ po _ ge,x 93 O y U ' <br /> !6N, <br /> L c ✓it!+ /4)-,---.2<;C Cy^'(.; :q-/ V ,( Gi J / j. ., <br /> Tax Parcel# 07O1/;•a3/?-05' //v <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 /> ACICNO%VLEDGEMENT / <br /> LL../ _.a t,..� <br /> ner N igna Owner Name('gnature) I t <br /> L-" LI' rre-vi <br /> Owner Name(Print) Owner r Name Srint) <br /> STATE OF WISCONSIN ) <br /> ) ss. <br /> COUNTY OF DANE ) <br /> Personally came before me this 30 day of N\ct >, it ZO1-i,the above named person(s) <br /> to me known to be the persons who executed the foregoing instrument and�cknowledged the same. <br /> 5 , o/ I- CESAR IVAN LOPEZ DIAZ <br /> NOTARY PUBLIC 6v - 0• :• t. (If nsin STATE OF WISCONSIN <br /> A <br /> ,.....it is permanent. (If not,expiration date is �� <br /> Public Health vladison Dane County EH 4!14 X1/4„/20 Z <br /> (9 <br />