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. • <br /> S..• <br /> 'a a Public Health <br /> MADISON &DANE COUNTY Thomas 1.Schlenker,MD,MPH,Director <br /> Healthy people and places Environmental Health Division 608 242.6515 Well&Septic <br /> 2701 International Lane,Suite 204 648 243-0330 Lic.Establishments <br /> Madison,WI 53704 608 242-6435 fax <br /> www.publichealthmdc.com <br /> July 9, 2009 POWTS#48870 <br /> EUGENE SPELLMAN <br /> 402 S 5TH ST <br /> MT HOREB WI 53572 <br /> Reference: NW 1/4 of NW 1/4 of Section 2, Town of Blue Mounds <br /> (no subdivision listed) <br /> Tax Parcel No: 0606---022---9080---6 <br /> Your property at: BERGUM ROAD <br /> Bergum Road <br /> Dear Eugene Spellman: <br /> Sanitary Permit#520342 was conditionally issued in your interest to your system installer on <br /> 7/10/2009. This permit is valid for two years (until 7/10/2011)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 />