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• <br /> . NL AND COMG <br /> `.n �, Division of Public Health <br /> • z Environmental Health Section <br /> DANE COUNTY Director—Helene M.Nelson <br /> Division Administrator—Gareth R.Johnson <br /> DEPARTMENT OF HUMAN SERVICES <br /> KATHLEEN M.FALIC <br /> DANE COUNTY EXECUTIVE <br /> PRELIMINARY OPINION OF SITE SUITABILITY <br /> FOR A PRIVATE SEWAGE SYSTEM DISPOSAL SYSTEM <br /> The Dane County Department of Human Services (hereinafter the <br /> "Department" ) has evaluated the site suitability of certain soils <br /> located in: <br /> City/ <br /> A/61/4, Su01/4, Sec. Z,5-- Town of : .5 ''42.T <br /> Lot Subd/CSM • for the <br /> I. If <br /> Owner/Buyer //4L V ,QSOr/ Property Address : /741/y, /4- <br /> installation of a private sewage system. The Department ' s review is <br /> based upon examination of (1) the "Soil and Site Evaluation Report" <br /> as submitted by the Certified Soil Tester, / 17' '/C/c t3A'BL3/7'7— <br /> CST #2209 and (2) the results of an on-site inspection by the <br /> Department . Based upon such examination, it is the opinion of <br /> the Department that the exact areas inspected appear to meet the <br /> minimum requirements of Wisconsin Administrative Code ch ILHR 83 for <br /> the installation of : <br /> . /v0 .Conventional Soil Absorption System (ILHR 83 . 12) <br /> /411° In-Ground Pressure Distribution System (ILHR 83 . 14) <br /> Mound System (ILHR 83 .23) <br /> ►/ At-Grade Mound System (ILHR 83 . 22) <br /> NO Holding Tank (ILHR 83 . 18) • <br /> Other: <br /> The above opinion is advisory only. Any disturbance to the exact <br /> area that was investigated, including compaction, excavation and <br /> filling or removal of soil, will invalidate this opinion. The <br /> Department reserves the right to require a new soil morphological <br /> evaluation as may become necessary to ensure compliance with all <br /> applicable codes prior to issuing a sanitary permit . <br /> DATE: //-3" 77 By the ivision <br /> 67(Name) <br /> i <br /> (Title) <br /> 1202 Northport Drive, Madison, Wisconsin 53704 • (608) 242-6515 • FAX(608) 242-6256 <br />