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o-'` <br /> r ..-:.e 1 , ttei., <br /> cc;. __ e \,' • . Dane County Public Health Department <br /> •�i %,,i( ',1206,NORTHPORT DRIVE, ROOM 107 • MADISON, WISCONSIN 53704 • PHONE (608) 241-4481 <br /> Division of Environmental Health <br /> DIVISION OF ADMINISTRATION Orville W. Hintz,R.S. <br /> Richard L.Crim,M.P.H. Director <br /> Health Officer August 24 , 1982 <br /> Division of Public Health Nursing <br /> Florence I.Wetzel,R.N. <br /> Director <br /> Kenneth Helgerson <br /> 5554 Enchanted Valley Rd. <br /> Cross Plains , WI 53528 ' <br /> Permit No . 28872 82-0273 <br /> Legal Description NWT NW Sec . 24 <br /> Berry Twp . <br /> Installer Joseph A Meiinhol z <br /> A PLB 68 Sanitary Permit has been conditionally issued in <br /> your interest to your installer. This permit is valid for two <br /> years and may be renewed or transferred as indicated on the face <br /> of the permit . <br /> A condition of the issuance of this permit is a tri-annual . <br /> maintenance required by NR 128 . 30( 6 ) (d)5 Wisconsin Administrative <br /> Code and by Dane County Chapter 46 . 11( 5 ) . These require that you, <br /> as owner, are to have this private sewage system serviced, documented <br /> by licensed person servicing system, and duly recorded at the <br /> Environmental Health Division of Dane County . <br /> You will be notified by the Environmental Health Division <br /> approximately 30 months after installation that servicing is due . <br /> Failure of notification will not relieve you of the obligation <br /> to have your system serviced. <br /> All heirs or assign of this property shall be notified of <br /> these requirements . ' <br /> If you have any questions , please contact this office . <br /> • <br /> Very truly yours, <br /> �/ f � ✓! <br /> 0. W. Hintz , I T --D-hector <br /> DANE COUNTY PUBLIC HEALTH DEPARTMENT <br /> ENVIRONMENTAL HEALTH DIVISION <br /> OWH:,j a s <br />