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PRIVATE ONSITE WASTEWATER TREATMENT <br /> SYSTEM COVENANT: UNDERSIZED SYSTEM <br /> "Bedroom Addition" <br /> This covenant is between <br /> grantors,and the County of Dane,regarding the private onsite wastewater <br /> treatment system(POWTS)on the following described parcel(s)located in the <br /> / <br /> Town of ' ,,;011 I. T0e`i <br /> in theN W*f theSWIof Section of b ,T N,R 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 /> Tax Parcel# D 7 0 V2-b 3la-t75 7/0 <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,l(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 <br /> Owner Name(Signature) Owner Name(Signature) <br /> Owner Name(Print) Owner Name(Print) <br /> STATE OF WISCONSIN <br /> ss. <br /> COUNTY OF DANE <br /> Personally came before me this day of 19 ,the above named person(s) <br /> to me known to be the persons who executed the foregoing instrument and acknowledged the same. <br /> Notary Public Dane County,Wisconsin <br /> My Commission is permanent. (If not,expiration date is <br /> Public Health Madison Dane County EH 4/14 <br />