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#�BCS <br /> • Public Health <br /> MADISON &DANE COUNTY Thomas l,.Schlenker,MD;MPH,Director <br /> Healthy people and places Environmental Health Division 608 242.6515 Well&Septic <br /> 2701 International Lane,Suite 204 608 243.0330 tic,Establishments <br /> Madison,WI 53704 608 242-6435 fax <br /> www.publicheatthmdc.com <br /> October 23, 2009 POWTS#48914 <br /> WILLIAM AND CINDY BEUTHIN <br /> 10129 MATHEWSON RD <br /> MAZOMANIE WI 53560 <br /> Reference: SW 1/4 of SW 1/4 of Section 3, Town of Mazomanie <br /> (no subdivision listed)CSM: 12764, Lot:2 <br /> Tax Parcel No: 0806---033---9070---0 <br /> Your property at: MATHEWSON RD <br /> Dear William and Cindy Beuthin: <br /> Sanitary Permit#520428 was conditionally issued in your interest to your system installer on <br /> 10/23/2009. This permit is valid for two years (until 10/23/2011)and may be renewed or transferred as <br /> indicated on the face of the permit. <br /> A condition of the issuance of this permit is a triennial maintenance required by s145.245, Wisconsin <br /> Statutes and by Dane County Code Chapter 46.11(5). These require that you, as owner,are to have <br /> this private sewage system serviced, documented by the licensed person servicing the system, and <br /> return the completed form to the Environmental Health Section of Dane County. There is a twenty six <br /> dollar($26.00)fee required by Chapter 46.23 (12)which must be submitted with the report. <br /> You will be notified by the Environmental Health Section approximately three months before the <br /> servicing is due. Failure 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 the <br /> Environmental Health Section are prohibited practices. All prohibited practices are subject to fines or <br /> 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 feel free to call me at 242-6515 between 7:45 and 9:30 AM <br /> Monday through Friday. <br /> Sincerely, <br /> John Hausbeck, Director <br /> Environmental Health Section <br /> 2701 International Lane,Rm 204,Madison,Wisconsin 53704 PHONE(608)242-6515 FAX(608)242-6435 <br />