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Safety and Buildings <br /> PO BOX 7162 <br /> commerce.wi.gov MADISON WI 53707-7162 <br /> TDD#:(608)264-8777 <br /> Dsco ns i n www.commerce.wi.gov/sb/7162 <br /> Department of Commerce www.wisconsin.gov <br /> Jim Doyle,Governor <br /> Mary P. Burke,Secretary <br /> June 28, 2006 <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 /> PLAN APPROVAL EXPIRES: 06/28/2008 Identification Numbers <br /> Transaction ID No. 1280070 <br /> SITE: Site ID No. 714406 <br /> Richard Adolphson-Dwelling Please refer to both identification numbers, <br /> 10812 Surrell Rd above,in all correspondence with the agency. <br /> Town of Wood River, 54840 <br /> Burnett County <br /> SE1/4,NW1/4, S24,T38N,R18W <br /> FOR: <br /> Description: Replacement Mound System/450 gpd <br /> Object Type: POWTS Component Manual Regulated Object ID No.: 1081361 <br /> Maintenance required; Replacement system; 450 GPD Flow rate; 18 in Soil minimum depth to limiting factor from <br /> original grade; System(s): Mound Component Manual-Version 2.0, SBD-10691-P(N.01/01),Pressure Distribution <br /> Component Manual-Version 2.0, SBD-10706-P(N.01/01) <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 s.145.06, <br /> stats. <br /> The following conditions shall be met during construction or installation and prior to occupancy or use: <br /> 1. On pages 2 and 4,the following adjustment was made to the total dynamic head(TDH)calculation as <br /> specified in product approval stipulation number 403 for the specified effluent filter: P( <br /> Cone <br /> Filter losses=0.50 ft <br /> TDH=18.69 ft Ap l 1 <br /> 2. On page 8,the well was not shown as specified in s.Comm 83.22(2)(a)3.c.,Wis.Adm.Code. The well Div . N <br /> location shall conform to s.Comm 83.43(8)(i).,Wis.Adm.Code. <br /> 3. On pages 8 and 9,the location of the existing onsite sewage system was not shown on the soil SEE <br /> CORFU <br /> evaluation report or system plot plans as specified in s.Comm 85.40(3)(a)4.,Wis.Adm.Code.,and <br /> the approved mound system component manual. This approval assumes that the mound system <br /> dispersal component will not be located over any portion of the existing onsite sewage system. All <br /> unused components of the existing onsite sewage system shall be properly abandoned as specified in s. <br /> Comm 83.33.,Wis.Adm.Code. <br />