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Safety and Buildings <br /> 10541 N RANCH ROAD <br /> CofmilerCemi.gov HAYWARD WI 54843. <br /> TDD#:(608)264-8777 <br /> isconsin wwwcommerisco sln.go, <br /> Department of Commerce www.wisconsin.gov <br /> Jim Doyle,Governor <br /> Cory L.Nettles,Secretary <br /> November 05,2004 <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: 11/05/2006 Identification Numbers <br /> Transaction ID No. 1076764 <br /> SITE: Site ID No.691735 <br /> Bamboozle Bar Please refer to both identification numbers, <br /> 2397 Cth a above,in all correspondence with theagency. <br /> Town of Scott <br /> Burnett County <br /> , S21,T40N,R14W <br /> Lot: 1, <br /> FOR: ('t)11 gfl <br /> Description:Replacement holding tank, 165 GPD based on pumping records <br /> Object Type: POWTS Component Manual Regulated Object ID No.: 989569 $ <br /> a jMl <br /> Maintenance required; Replacement system; 165 GPD Flow rate; System(s): Holding Tank Component Manual,Si -,NOF `• <br /> 10571-P(r.6/99) <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 owner,as defined in <br /> chapter 101.01(10),Wisconsin Statutes,is responsible for compliance with all code 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 /> Key Item(s) <br /> • This approval is for a 1800 square foot bar serving food,all paper service with 3 employees,a 1 bedroom <br /> apartment and an office with 4 employees. The design wastewater flow is determined from tank <br /> pumping records.If the type of food served or the method of food preparation or service changes,the <br /> POWTS shall be reevaluated to determine whether the system is appropriate for the food service. <br /> • This system is to be constructed and located in accordance with the enclosed approved plans and with the <br /> "Holding Tank Component Manual, SBD-10571-P(R.6/99)" <br /> • In the event this holding tank malfunctions so as to create a health hazard,the property owner must follow the <br /> contingency plan as described in the approved plans. In addition, the owner must insure that the operation, <br /> maintenance and monitoring duties as described the Holding Tank Component Manual are complied with. A <br /> copy of this information must be given to the owner upon completion of the project. <br /> • The existing septic tank must be inspected for structural soundness and size and must be brought into <br /> conformance with the requirements of COMM 83,Wis.Adm.Code. If it does not conform a state <br /> approved tank must be installed. <br /> • A service road shall be provided within 25 feet of all holding tank manholes. <br />