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a AV ANA Coyly <br /> Division of Public Health <br /> .1% ii IP op 04 <br /> • t Environmental Health Section <br /> , g • Director-Lynn Green <br /> DA + COUNTY 1 Division Administrator-Gareth R.Johnson <br /> DEPARTMENT OF HUMAN SERVICES <br /> KATHLEEN M.FALK <br /> DANE COUNTY EXECUTIVE <br /> PRELIMINARY OPINION OF SITE SUITABILITY <br /> FOR A PRIVATE ONSITE WASTEWATER TREATMENT SYSTEM <br /> The Dane County Department of Human Services(hereinafter the"Department")has evaluated <br /> the site suitability of certain soils located in: <br /> /t./ 1/4,. 1/4, Seca I City/Town of: .Srcv:z/" ci c.'° <br /> Lot 36 Subdivision/CSM Z3'e AO�� i 43'G <br /> OwnerBuyer ,5;°,2./A..) ,�� 'e-.o "0.42 d,o��7—ins Z. e%a.7- o 'Co v 'o/". <br /> Property Address Gfzi4,''it°./bxt'S ,Q UN <br /> for the installation of a private sewage system. The Department's review is based upon <br /> examination of(1)the"Soil and Site Evaluation report"CST#ZZsubmitted 09 eared)the results of <br /> Tester, ,.5�'V�' �`as�'y <br /> an on-site verification inspection by the Department. Based upon such examination,it is the <br /> opinion of the Department that the exact areas inspected appear to meet the minimum <br /> requirements of Wisconsin Administrative Code ch COMM 83 for the installation of: <br /> t-Conventional Soil Absorption System <br /> In-Ground Pressure Distribution System <br /> Mound System <br /> — <br /> At-Grade Mound System <br /> Holding Tank . <br /> Other: <br /> The final system design must comply with all state and County code criteria,including a <br /> minimum of 3 soil pits per system area. <br /> The above opinion is advisory only. Any disturbance or unapproved alteration to the exact area . <br /> that was investigated will invalidate this opinion.The Department reserves the right to require a <br /> new soil morphological evaluation as may become necessary to ensure compliance with all <br /> applicable codes prior to issuing a sanita ermit. � <br /> DATE: ,0 —!6 — 0.3 �• +C) <br /> ' cref„),... ....„.....L.0 <br /> (Title). <br /> 1202 Northport Drive,Madison,Wisconsin 53704•(608)242-6515•FAX(608)242-6435 0 <br />