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NOV-26-97 WED 05:20 PM DR LAURA KNIPFER 608 655 3715 P.05 <br /> • '.40ti4N 1.AND Cp,kM"`). <br /> 4) Division of Public Ilealth <br /> Environmental Health Section <br /> DANE COUNTY Director—Susan Crowley <br /> lJ 1�1 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 /> • <br /> FOR A PRIVATE SEWAGE SYSTEM DISPOSAL SYSTEM <br /> The Dane County Department of Human Services(hereinafter the"Department")has evaluated <br /> the site suitability of certain soils located in: <br /> -SW /�j� <br /> � 1/4, N6"1/4,Sec./5 Cityt1 own • : em/A-91 <br /> Lot Subdivision/CSM V 12c-ft5; cgAti <br /> Owner/Buyer/1111C t ii P t-- Property Address C1--4 IC1T E. <br /> for the installation of a private sewage system. The Department's review is based upon <br /> examination of(1)the oil and Site Evaluation report" as submitted by the Certified Soil <br /> Tester, tet_V. gArmiseirc CST# (906 and(2)the results of <br /> an on-site inspection by the Department. Based upon such examination,it is the opinion of the <br /> Department that the exact areas inspected appear to meet the minimum requirements of <br /> Wisconsin Administrative Code ch COMM 83 for the installation of: <br /> Conventional Soil Absorption System(COMM 83.12) <br /> In-Ground Pressure Distribution System(COMM 83.14) <br /> Mound System(COMM 83.23) <br /> At-Grade Mound System(COMM 83.22) <br /> Holding Tank(COMM 83.18) <br /> Other: <br /> • <br /> The above opinion is advisory only. Any disturbance to the exact area that was investigated, <br /> including compaction,excavation and filling or removal of soil,will invalidate this opinion. The <br /> Department reserves the right to require a new soil morp • •gical evaluation as may become <br /> necessary to ensure compliance with all applicable •••twor to issuing a sanitary permit. <br /> DATE: r'°-/3 -9:7- `;1y�i�%//j <br /> - L <br /> (Name) <br /> (Title) <br /> 1202 Northport Drive,Madison,Wisconsin 53704 • (608)242-6515 • FAX(608)242-6256 <br /> i� <br /> NO. 7- �6 7 <br /> � ,,� i3 19�? <br /> RECEIVED FROM <br /> `-DOLLARS <br /> Account Tote1 $ <br /> Amount Pa■ci $ <br /> ealence Cue $ <br /> *NE EFFICIENCY•L WE..AN Alamo ogoUUGt <br />