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AND cow <br /> e Division of Public Health <br /> tt Environmental Health Section <br /> °4 COUNTY`` te Director—Lynn Green <br /> DANE lr Division Administrator—Gareth R.Johnson <br /> DEPARTMENT OF SEAMAN SERVICES <br /> KATHLEEN M.FALK <br /> DANE COUNTY EXECUTIVE <br /> PRELIMINARY OPINION OF SITE SUITABILITY <br /> FOR A PRIVATE ONS1TE WASTEWATER TREATMENT SYSTEM <br /> The Dane County Department of Human Services(hereinafter the"Department")has evaluated <br /> the site suitability of certain soils located in: <br /> Al 10 1/4,Al CU 1/4, Seca.' 2-City/Town of: <br /> Lot 3 SubdivisioiiC( ) /0 `7 a S <br /> Owner/Buyer @ p a LA ej! ( <br /> • <br /> Property Address <br /> for the installation of a private sewage system_ The Department's review is based upon <br /> examination of )the d Site Evaluation report"as submitted by the Certified Soil <br /> Tester, p CST#ZZ 59' nd(2)the results of <br /> an on-site verification inspeZ by the Department. Based upon such examination, it is the <br /> opinion of the Department that the exact areas inspected appear to meet the minimum - <br /> requirements of Wisconsin Administrative Code ch COMM 83 for the installation of: <br /> Conventional Soil Absorption System <br /> In-Ground Pressure Distribution System <br /> H 'Mound System "7 d- kt 1 y y\ a 4- <br /> f ,, <br /> At-Grade Mound System <br /> Holding Tank <br /> Other: <br /> The final system design must comply with all state and County code criteria,including a <br /> minimum of 3 soil pits per system area. <br /> The above opinion is advisory only. Any disturbance or unapproved alteration to the exact area <br /> that was investigated will invalidate this opinion. The Department reserves the right to require a <br /> new soil morphological evaluation as may become necessary to ensure compliance with all <br /> applicable codes prior to issuing a sanitary permit. - <br /> DATE: C `7 —0 Li <br /> (Name) p/ �/� <br /> (Title) <br /> 1202 Northport Drive,Madison,Wisconsin 53704•(608)242-6515•FAX(608)242-6435 <br /> • <br />