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•• . Public Health Jane! Heinrich, MPH, MA, Director <br /> MADISON & DANE COUNTY Environmental Health Division (608)242-6515 Well&Septic <br /> Healthy people.Healthy places. 2300 S Park St,Suite 2010 (608)242-6515 Lic. Establishments <br /> Madison,WI 53713 (608)242-6435 fax <br /> www.publichealthmdc.com (608)267-1989 Animal Control- <br /> Mail Voicemail <br /> February 28, 2018 POWTS ID: <br /> 13-2018-00039 <br /> Mia K Kahl <br /> 700 N Page St <br /> Stoughton, WI 53589 <br /> Reference: Tax Parcel Number: 0512-053-9700-7 <br /> SE 1/4 of SW 1/4 of Section 5, <br /> Property Address: <br /> CSM 02384 Lot: 1 <br /> Owner Name: Mia K Kahl <br /> Dear Mia K Kahl <br /> Sanitary Permit#13-2018-00039 was conditionally issued in your interest to your system installer on <br /> 02/28/2018. This permit is valid for two years (until 02/28/2020) 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 that you, as owner of this private septic system, <br /> ensure that appropriate system inspection and maintenance is performed as required by s145.245, <br /> Wisconsin Statutes and by Dane County Code Chapter 46.11(5). The appropriate inspection and <br /> maintenance for your system is described in the private septic system management plan provided by your <br /> installer. The licensed professional that you hire <br /> to perform this service will document their results on forms provided by Public Health Madison and Dane <br /> County. These forms must be submitted to this Department for your system to be in compliance with State <br /> and County laws. Fees associated with this program will be assessed annually on the property tax bill. <br /> Currently this fee is$8.67 per year. <br /> You will be notified by the Environmental Health Section approximately three months before the servicing is <br /> due. Faiure of notification will not relieve you of the obligation to have your system serviced. Failure to either <br /> have the private sewage system serviced or failure to report same to the Environmental Health Section are <br /> prohibited practices. All prohibited practices are subject to fines or forfeitures as specified by County <br /> 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 contact me at (608) 242-6515 between 8:00 and 9:00 AM <br /> Monday through Friday. <br /> Sincerely, <br /> 19#5:111‘''2 <br /> John Hausbeck <br /> Environmental Health Services Supervisor <br />