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NOV-26-97 WED 05:20 PM DR LAURA KNIPFER 608 655 3715 P.05 <br /> • <br /> r '.�Q`4`Jn�AND Co MMG/TA <br /> �44, Division of Public Health <br /> Environmental Health Section <br /> DANE COUNTY Director—Susan Crowley <br /> V lJ J. 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 /> 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 certai n soils located in: <br /> 1/4, X51/4,Sec./V City lown. : Ada/A-91 <br /> Lot Subdivision/CSM <br /> Owner/Buyer M1i i PFR---- Property Address T11 1. <br /> for the installation of a private sewage system. The Department's review is based upon <br /> examination of(1)alp oil and Site Evaluation report" as submitted by the Certified Soil <br /> Tester, Mrz_V. bigiternIderr 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 /> Q� 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 /> 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 .../�f or to issuing a sanitary permit. <br /> DATE: /e)-/s -9-7- <br /> (Name) <br /> (Title) <br /> 1202 Northport Drive,Madison,Wisconsin 53704 •(608)242-6515 •FAX(608)242-6256 <br /> ie <br /> NO. -7- <br /> 19�7 <br /> RECEIVED FROM �?4, <br /> ~flQLLARS <br /> Account Tote/ $ <br /> w <br /> Amouht Paid $ J <br /> Balance bue $ <br /> S2f <br /> 045 P ICtr,[r•J E AN AMMO 0000u <br />