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Safety and Buildings <br /> 10541 N RANCH ROAD <br /> commercemi.gov HAYWARD WI 54843 <br /> TDD#:(608)264-8777 <br /> tiepartment sconsin www.commerc .wis onsin.govwww.wisconsin.gov of Commerce <br /> Jim Doyle,Governor <br /> Cory L.Nettles,Secretary <br /> April 02,2004 <br /> CUST ID No.227691 ATTN:POWTS Inspector <br /> WADE A RUFSHOLM ZONING OFFICE <br /> 24702 LIND RD BURNETT COUNTY SPIA <br /> PO BOX 514 7410 CTH K#102 <br /> SIREN WI 54872 SIREN WI 54872 <br /> CONDITIONAL APPROVAL <br /> Identification Numbers <br /> PLAN APPROVAL EXPIRES: 04/02/2006 <br /> Transaction ID No.982959 <br /> SITE: Site ID No.672277 <br /> John Johnson Please refer to both identification numbers, <br /> Ice House Bridge Rd above,in all correspondence with the agency. <br /> Town of Lincoln <br /> Burnett County <br /> SWI/4,NE1/4, S28,T39N,R17W <br /> FOR: <br /> Description:New mound,3 brdm residence <br /> Object Type:POWTS Component Manual Regulated Object ID No.: 948785 <br /> Maintenance required; 450 GPD Flow rate; 20 in Soil minimum depth to limiting factor from original grade; <br /> System(s):Mound Component Manual-Version 2.0,SBD-10691-P(N.01/01) <br /> p,p.W <br /> The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes C 011 dit1 <br /> and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner,as defined in <br /> chapter 101.01(10),Wisconsin Statutes,is responsible for compliance with all code requirements. <br /> No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, <br /> stats. <br /> of `AFE <br /> The following conditions shall be met during construction or installation and prior to occupancy or use: <br /> General Approval Conditions: <br /> • This system is to be constructed and located in accordance with the enclosed approved plans and with the <br /> design manuals noted above. <br /> • In the event this soil absorption system or any of its component parts malfunctions so as to create a health <br /> hazard,the property owner must follow the contingency plan as described in the approved plans.In addition, <br /> the owner must insure that the operation,maintenance and monitoring duties as described in section VIII of <br /> the mound component manual are complied with.A copy of this information must be given to the owner upon <br /> completion of the project. <br /> Key Item(s) <br /> • The contour line elevation below the upper edge of the dispersal cell shall be 97.1',not 91.1'. Changes made <br /> to pages 2,3 and 4 reflect this fact. <br /> • The tank access openings shall be per Comm 84.25(7). <br /> • The designer proposes to install a state approved effluent filter to achieve the requirement of wastewater <br /> particle size. Pursuant to outlet filter product approval stipulations,maintenance information must be given to <br /> the owner of the POWTS explaining that periodic cleaning of the effluent filter is required. The access opening <br /> used to service the filter shall terminate at or above fmished grade with a watertight cover. <br />