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*' Public Health <br /> MADISON & DANE COUNTY Janel Heinrich,MPH,MA,Director <br /> Healthy people and places Environmental Health Division 608 242-6515 Well&Septic <br /> 2701 International Lane,Suite 204 608 243-0330 Li.Establishments <br /> Madison,WI 53704 608 242-6435 fax <br /> www.publichealthmdc.com <br /> March 17,2015 POWTS#13-2015-00055 <br /> MC MAHAN REV TR,PERRY AND PATRICIA <br /> 1144 PRIMROSE CENTER RD <br /> MT HOREB,WI 53572 <br /> Reference: Tax Parcel No:0507-103-9180-7 <br /> SW 1/4 of SW 1/4 of Section 10,TOWN OF PRIMROSE <br /> Property Address: 1144 PRIMROSE CENTER RD <br /> CSM:02916 Lot: 1 <br /> Owner Name: Mc Mahan Rev Tr, Perry And Patricia <br /> Dear Mc Mahan Rev Tr, Perry And Patricia: <br /> Sanitary Permit#13-2015-00055 was conditionally issued in your interest to your system <br /> installer on 03/17/2015.This permit is valid for two years(until 03/17/2017)and may be renewed <br /> or transferred as indicated on the face of the permit. <br /> A condition of the Issuance of this permit is that you, as owner of this private septic system, <br /> ensure that appropriate system inspection and maintenance is performed as required by <br /> s145.245,Wisconsin Statutes and by Dane County Code Chapter 46.11(5).The appropriate <br /> inspection and maintenance for your system is described in the private septic system <br /> management plan provided by your installer.The licensed professional that you hire <br /> to perform this service will document their results on forms provided by Public Health Madison <br /> and Dane County.These forms must be submitted to this Department for your system to be in <br /> compliance with State and County laws. Fees associated with this program will be assessed <br /> annually on the property tax bill. Currently this fee is$8.67 per year. <br /> You will be notified by the Environmental Health Section approximately three months before the <br /> servicing is due.Faiure of notification will not relieve you of the obligation to have your system <br /> serviced. Failure to either have the private sewage system serviced or failure to report same to <br /> the Environmental Health Section are prohibited practices.All prohibited practices are subject to <br /> fines or forfeitures as specified by County Ordinance. <br /> All heirs or assigns of this property shall be notified of these requirements. <br /> If you have any questions,please fell free to call me at 242-6515 between 7:45 and 9:30 AM <br /> Monday through Friday. <br /> Sincerely, <br /> 7S24. <br /> John Hausbeck <br /> Environmental Health Services Supervisor <br />