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Safety and Buildings <br /> 10541N RANCH ROAD <br /> HAYWARD WI 54843 <br /> TDD M(608)264-8777 <br /> N*hsconsin <br /> www.commerce.state.wi.us/sb <br /> Department of Commerce www.wisconsin.gov <br /> Jim Doyle,Governor <br /> Cory L.Nettles,Secretary <br /> November 06,2003 <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: 11/06/2005 Identification Numbers <br /> Transaction ID No.934936 <br /> SITE• Site ID No.667356 <br /> Richard Cunningham Please refer to both identification numbers, <br /> 2262 North Shore Dr above,in all correspondence with the agency. <br /> Town of Wood River, 54840 <br /> Burnett County <br /> ,S27,T38N,R18W <br /> Lot: 6, Subdivision:N.shore Island Sub <br /> FOR:replacement 450 gpd mound <br /> Object Type: POWT System Regulated Object ID No.: 927629 <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 /> The following conditions shall be met during construction or installation and prior to occupancy or use: <br /> • Existing tank must be checked for structural integrity. <br /> • Existing tank must have filter,as shown in plan. This filter must restrict particles over one eight inch in size. <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 /> In granting this approval the Division of Safety&Buildings reserves the right to require changes or additions <br /> should conditions arise making them necessary for code compliance.As per state stats 101.12(2),nothing in this <br /> review shall relieve the designer of the responsibility for designing a safe building,structure,or component. <br /> Inquiries concerning this correspondence may be made to me at the telephone number listed below,or at the address <br /> on this letterhead. <br /> The above left addressee shall provide a copy of this letter to the owner and any others who are responsible for the <br /> installation,operation or maintenance of the POWTS. <br /> Sincerely, Fee Required$ 175.00 <br /> f Fee Received$ 175.00 <br /> � j� Balance Due $ 0.00 <br /> Carl J Lip$e <br /> Wastewater Specialist,Integrated Services WiSMART code:7633' <br /> (715)634-3484, <br /> clippert@commerce.state.wi.us <br />