12-04-2014 - variance agreement for well

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MIill DEPARTMENToF HEALTH Protecting, maintaining and improving the health of all Minnesotans December 4,2014 Refer to: TN 5161 Mr.Kenneth J.Fasola Mrs. Tenley D. Fasola 1000 Wildhurst Trail Mound, Minnesota 55364 Dear Mr. and Mrs. Fasola: Subject: Variance Agreement for the Unlocated,Unused,Unsealed Water-Supply Well at 1000 Wildhurst Trail, Orono,Hennepin County,Minnesota,Property Identification Number 07-117-23-13-0217 Enclosed are two original copies of the variance agreement.In order to validate the variance agreement,you must: 1. Sign the agreement in the presence of a notary public.Be sure to have the notary public acknowledge your signatures in the appropriate blocks on page 4 of the agreement. 2. Deliver the signed variance agreement to the Hennepin County Office of Registrar of Titles,where the agreement must be filed with the certificate of title for the property.The Torrens certificate number used to file the variance agreement is 1380922.The Hennepin County Office of Registrar of Titles is located in the Hennepin County Public Records Division at A-500 Government Center, 300 Sixth Street South, Minneapolis,Minnesota 55487-0500.The telephone number is 612-348-5139.If you are planning to submit this document to Hennepin County by mail,first contact the county to assure that the necessary filing fee and any other required information are included. 3. Forward a copy of all pages of the filed document to my attention: Mr.Edward Schneider,Minnesota Department of Health, Well Management Section,625 Robert Street North,P.O.Box 64975, St.Paul,Minnesota 55164-0975.The forwarded document must be marked by the county registrar of titles,verifying that the document has been filed. Please note that the agreement is made between the Minnesota Department of Health(MDH)and you,Kenneth J. and Tenley D. Fasola,the fee owners. You must sign the agreement,have it filed at the Hennepin County Office of Registrar of Titles,and provide one copy of all pages of the filed document to the MDH.The variance must be filed while you are still the fee owners of the property. If the property is being sold, it is acceptable to file the variance agreement at the same time that property transfer documents are recorded.Failure to comply with these terms may nullify the variance. It should also be noted that the variance does not eliminate the requirement to seal the well. It only postpones sealing until the well is located and becomes accessible,or it is ordered sealed by the commissioner of health. If you have any questions,please contact me at 651-201-4595. Sincerely, Edward C. Schneider,Hydrologist Well Management Section P.O. Box 64975 St. Paul,Minnesota 55164-0975 ECS:PTS:dg cc: Building Official,City of Orono General Information: 651-201-5000 • Toll-free: 888-345-0823 • www.health.state.mn.us An equal opportunity employer