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otir*ark��r DIVISION OF INDUSTRY SERVICES <br /> 10541 N RANCH RD <br /> 9 HAYWARD WI 54843-6462 <br /> 8� O s IA) Contact Through Relay <br /> http://dsps.wi.gov/programs/industry-services <br /> www.wisconsin.gov <br /> �O�'ssION xt Scott Walker,Governor <br /> Dave Ross,Secretary <br /> May 02,2016 <br /> CUST ID No. 227691 ATTR POWTSInspector <br /> WADE A RUFSHOLM ZONING OFFICE <br /> 24702 LIND RD BURNETT COUNTY SPIA <br /> PO BOX 514 7410 CTH K#102 <br /> SIREN WI 54872-0514 SIREN WI 54872 <br /> CONDITIONAL APPROVAL <br /> PLAN APPROVAL EXPIRES: 05/02/2018 Identification Numbers <br /> Transaction ID No.2696683 <br /> SITE• Site ID No. 823096 <br /> Tim Dahlberg Please refer to both identification numbers, <br /> 23436 Little Wood Lake Rd above,in all correspondence with theagency. <br /> Town of Wood River <br /> Burnett County <br /> SWI/4,NW1/4, S24,T38N,R18W <br /> FOR: <br /> Object Type: POWTS Component Manual Regulated Object ID No.: 1596583 <br /> Maintenance required; 450 GPD Flow rate; 23 in Soil minimum depth to limiting factor from original grade; System(s): <br /> Mound Component Manual-Ver.2.0, SSD-10691-P(N.01/01,R. 10/12), Pressure Distribution Component Manual- <br /> Ver. 2.0, SBD-10706-P(N.01/01, R. 10/12); Effluent Filter <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 any 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 /> Reminders <br /> • Pursuant to outlet filter product approval stipulations, maintenance information must be given to the owner of <br /> the POWTS explaining that periodic cleaning of the septic tank outlet filter is required. The access opening <br /> used to service the filter shall terminate at or above finished grade with a watertight cover. <br /> • The existing septic tank must be inspected for structural soundness,size and baffles and must be brought into <br /> conformance with the requirements of ch. Comm 83,Wis.Adm.Code. If it does not conform,a state-approved <br /> tank must be installed. <br /> A copy of the approved plans, specifications and this letter shall be on-site during construction and open to <br /> inspection by authorized representatives of the Department,which may include local inspectors. All permits <br /> required by the state or the local municipality shall be obtained prior to commencement of <br /> construction/installation/operation. <br />