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Safety and Buildings <br /> 10541N RANCH ROAD <br /> commerceml.gov HAYWARD WI 54843 <br /> C ntactThrough Relay <br /> tiepartmentsconsin www ommerisconsin.govwww.wisconsin.gov of Commerce <br /> Jim Doyle,Governor <br /> Aaron Diver,Secretary <br /> May 17,2010 <br /> CUST ID No. 224069 ATTN:POWTS Inspector <br /> KELLY M FERGUSON ZONING OFFICE <br /> DOCK LAKE SEPTIC&DIRT WORK BURNETT COUNTY SPIA <br /> W9502 DOCK LAKE RD 7410 CTH K#102 <br /> SPOONER WI 54801 SIREN WI 54872 <br /> CONDITIONAL APPROVAL <br /> PLAN APPROVAL EXPIRES: 05/17/2012 Identification Numbers <br /> Transaction ID No. 1791119 <br /> SITE: Site ID No. 756271 <br /> Eugene Bryski Coffee Shop Please refer to both identification numbers, <br /> 28811 Co Rd H above,in all corres ondenc with theagency. <br /> Town of Scott <br /> Burnett County <br /> SW1/4, SETA, S09,T40N,R14W W' <br /> FOR: ndift <br /> Description: Conventional system,25 seat coffee shop,2 employees,all paper service cO <br /> Object Type:POWTS Component Manual Regulated Object ID No.: 1264471 P <br /> Maintenance required; Replacement system; 414 GPD Flow rate; 110 in Soil minimum depth to inviting factor NI <br /> original grade; System(s): Conventional POWTS Component Manual, SBD-10567-P(R.6/99); Commercial Syste so <br /> Effluent Filter K� <br /> The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Cod SEE COBB' <br /> and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be cons cted <br /> and located in accordance with the enclosed approved plans and with any component manual(s)refere ced above. <br /> The owner,as defined in chapter 101.01(10),Wisconsin Statutes,is responsible for compliance with al I code <br /> requirements. <br /> No person may engage in or work at plumbing in the state unless licensed to do so by the Department r er s.145.06, <br /> stats. <br /> The following conditions shall be met during construction or installation and prior to occupancy or use <br /> Key item(s) <br /> • In the event this soil absorption system or any of its component parts malfunctions so as to created health <br /> hazard,the property owner must follow the contingency plan as described in the approved plans.11 addition, <br /> the owner must insure that the operation,maintenance and monitoring duties as described in the " -Ground <br /> Soil Absorption Manual System" are complied with.A copy of this information must be given to he owner <br /> upon completion of the project. <br /> • This approval does not include plans for the general plumbing systems or sewer piping leading to he <br /> septic/holding tank that may be required for this project. See section COMM 82.20,Wis.Adm. C de,to <br /> determine if plan submittal and approval is required. <br /> • This system is designed for wastewater strength with monthly averages of less than or equal to 30 mg/L of fats, <br /> oils and grease,less than or equal to 220 mg/L of biochemical oxygen demand and less than or eq ial to 150 <br /> mg/L total suspended solids. <br /> • If the type of food served or the method of food preparation or service changes,the POWTS shall be <br /> reevaluated to determine whether the system is appropriate for the food service. <br />