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POWTS AGREEMENT <br /> Document if I Document Tide <br /> T agreement is made between:l auras td. 0.4,d CI x�tsfi h a 1 . <br /> We 4.s e,rx and the County <br /> of Dane regarding the Private Onsite Wastewater Treatment System(POWTS) <br /> located in the Town of Chris-Wan a` . <br /> In the X1/4 of the ASE1/4 of SectiotkaTaN.,R 12 B. <br /> Specifically:(Type or neatly print the complete legal description ofyour property <br /> in the space below.The legal descriptian is your deed and usua on your tax <br /> bil.)Te cn�{he ` %1 of'+ha HortAu$cs1 t/f of See- 'an 31 <br /> "A'Wei Os b //a.{{,r R� a l2 E 1,ill -1-At Tom of Ck,mfia� <br /> Dane �4i wtscar►s'r A PXC_EPt .Mc FAST goo-N/A. -1ircrto <br /> o,,~c+ also Except -rite. �u.--4h 33-Pee# -1-ilea.S. <br /> Recording h ffarmadon: <br /> House located at 1746 State Highway 73.Town of Christiana,Dane County,WI <br /> Parcel Number 0612-342-9580-1 Ywaltaa a�iteasw Adfdnsr: <br /> -ThotiLm5 W a-wd l rrs+rn Sort <br /> 114 (o t. ►f 'hr.-0-'j <br /> bolt bri4G 3 ;z3 <br /> tsl.1 A 3lta 9s TO I <br /> Tax Parcel Number <br /> Atthe above named location®(I)❑(We),plan to(check all that apply): <br /> ® Build a house addition or remodel an existing house resulting in an increase in , <br /> ❑ Build a replacement residence or additional structure and conned it to an existing POWTS, <br /> ❑ Build an Additional Structure and connect it to an existing POWTS. <br /> The existing POWTS has been determined to be in compliance with bedrock and groundwater standards contained in Wisconsin <br /> Administrative Code(COMM83).0(1)❑(We)understand that the sizing determination of the existing POWTS is being based on <br /> the number of people living in the house in lieu of total bedrooms.The total number of people utilizing the existing POWTS will bell <br /> maximum of 6 people. •( L. 1.d� nrrc) <br /> Owner's Signature <br /> O.0,AY Pim._ - OT i air / i7 <br /> Date <br /> MARY H. * <br /> Subscribed a�swollen,before me BEHLING <br /> This I V' day o 201:1_/ 4)._ 5� <br /> Wary N• : col wlsG# <br /> �ty,Wisconsin "'�' D fad d y <br /> My Commissi Ls A A51— - wit dr•- <br /> C IV <br /> 104/2017 t Thb lestourast Dobai by Pslik Bdtlak&cos&Dose Covey <br /> et <br />