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Safety and Buildings <br /> 4003 N KINNEY COULEE RD <br /> LA CROSSE WI 54601-1831 <br /> I <br /> TDD#:(608) .wi.us 77 <br /> Misconsin www.comm ww.wisconsin.gov <br /> www.wiswnsin.gov <br /> Department of Commerce <br /> Scott McCallum,Governor <br /> Philip Edw.Albert,Acting Secretary <br /> September 11,2001 <br /> CUST ID No.225851 A777V.• POWTS Inspector <br /> RICHARD HOPKINS ZONING OFFICE <br /> HOPKINS SAND&GRAVEL BURNETT COUNTY SPIA <br /> 27760 HWY 35 7410 CTH K#102 <br /> WEBSTER WI 54893 SIREN WI 54872 <br /> CONDITIONAL APPROVAL Identification Numbers <br /> PLAN APPROVAL EXPIRES:09/11/2003 Transaction ID No.670960 <br /> Site ID No.635160 <br /> SITE: Please refer to both identification numbers, <br /> Gary Chesebro-2895 CTH A above, in all corres ondence with theagency. <br /> Burnett County,Town of Scott <br /> Subdivision/CSM: Volume 13,Page 128,Block#1,Lot#2-Oak Lake Addition No. 1 <br /> FOR: <br /> Description: Three Bedroom Mound System <br /> Object Type: POWT System Regulated Object ID No.: 809319 <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.The following conditions shall <br /> be met during construction or installation and prior to occupancy or use: <br /> General Approval Requirements: <br /> • This system is to be constructed and located in accordance with the enclosed approved plans and with the <br /> "Mound Component Manual for Private Onsite Wastewater Systems VERSION 2.0" SBD-10691-P(N.01/01) <br /> and the"Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems VERSION <br /> 2.0" SBD-10706-P(N.01/01). <br /> • A Sanitary Permit must be obtained from the county where this project is located in accordance with the <br /> requirements of Sec. 145.135 and 145.19,Wis.Stats. <br /> • Inspection of the private sewage system installation is required.Arrangements for inspection shall be made with <br /> the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stats. <br /> Owner Responsibilities: <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. <br /> • The owner must insure that the operation,maintenance and monitoring duties as described in section VIII of the <br /> mound component manual are complied with.A copy of the instructions and information regarding proper <br /> use and maintenance of the system must be given to the owner and each subsequent owner upon <br /> completion of the project. <br /> • The activities relating to evaluation and monitoring mechanical POWTS components after the initial installation <br /> of the POWTS in accordance with an approved management plan shall be conducted by a person who holds a <br /> registration issued by the department as a registered POWTS maintainer. <br />