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Safety and Buildings <br /> commerce.wi.gov PO BOX 7162 <br /> MADISON WI 53707-7162 <br /> ■ ■ TDD#:(608)264-8777 <br /> isconsin <br /> www.commerce.wi.gov/sb/ <br /> Department of Commerce <br /> www.wisconsin.gov <br /> Jim Doyle,Governor <br /> Mary P.Burke,Secretary <br /> June 21,2006 <br /> CUST ID No. 227691 ATTIC•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 /> PLAN APPROVAL EXPIRES: 06/21/2008 Identification Numbers <br /> SITE: Transaction ID No.1280085 <br /> Tim Dahlberg Site ID No. 714407 <br /> Surrell Rd Please refer to both identification numbers, <br /> Town of Wood River above,in all correspondence with theagency. <br /> Burnett County <br /> SW1/4,NW1/4,S24,T38N,R18W <br /> FOR: <br /> Object Type: POWTS Component Manual Regulated Object ID No.: 1081367 <br /> Maintenance required; 450 GPD Flow rate; System(s):Mound Component Manual-Version 2.0,SBD-10691-P <br /> (N.01/O1) <br /> The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes <br /> and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be constructed <br /> and located in accordance with the enclosed approved plans and with the component manual(s)referenced above. <br /> The owner,as defined in chapter 101.01(10),Wisconsin Statutes,is responsible for compliance with all code <br /> requirements. <br /> No person may engage in or work at plumbing in the state unless licensed to do so by the Department per <br /> s.145.06,stats. P.0'Vk <br /> The following conditions shall be met during construction or installation and prior to occupancy or use: ; ` . <br /> Conti <br /> • Numbered soil borings shall be clearly shown on the plot plans of all future designs. <br /> i i 4 <br /> A copy of the approved plans,specifications and this letter shall be on-site during construction and open to � y::`t <br /> inspection b authorized representatives of the Department,which may include local inspectors. All permits 5q_ � I' V.iLl <br /> Y p p � Y p <br /> required b the state or the local municipality ��yt �� <br /> q y p ty shall be obtained prior to commencement of <br /> construction/installation/operation. w-- - <br /> In granting this approval the Division of Safety&Buildings reserves the right to require changes or additions should <br /> conditions arise making them necessary for code compliance.As per state stats 101.12(2),nothing in this review <br /> shall relieve the designer of the responsibility for designing a safe building,structure,or component. <br /> Inquiries concerning this correspondence may be made to me at the telephone number listed below,or at the address <br /> on this letterhead. <br /> The above left addressee shall provide a copy of this letter to the owner and any others who are responsible for the <br /> installation,operation or maintenance of the POWTS. <br /> Sincerely, Fee Required$ 175.00 <br /> Fee Received$ 175.00 <br /> Balance Due $ 0.00 <br /> __-�_-- <br />