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Safety and Buildings <br /> 4003 N KINNEY COULEE RD <br /> LACROSSE WI 54601-1831 <br /> TDD <br /> TDD#:(608)264-8777 <br /> isconsin <br /> www.comrnerce.state.wI.us/sb <br /> ov <br /> www.wisconsin.gov <br /> Department of Commerce <br /> Scott McCallum,Governor <br /> Brenda J.Blanchard,Secretary <br /> June 29,2001 <br /> CUST ID No.227691 A777V: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: 06/29/2003 Identification Numbers <br /> Transaction ID No.655525 <br /> SITE: Site ID No.631740 <br /> Rob Danielson-Anchor Inn Road Please refer to both identification numbers, <br /> Burnett County,Town of La Follette above,in all correspondence with theagency. <br /> Subdivision: CSM-Volume 16,Page 143 and 144-lot 5 <br /> S5,T38N,R15W <br /> FOR: <br /> Description:Three Bedroom Mound System <br /> Object Type: POWT System Regulated Object ID No.: 798586 <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 following conditions shall <br /> be met during construction or installation and prior to occupancy or use: <br /> • This system is to be constructed and located in accordance with the enclosed approved plans and with the <br /> "Mound Component Manual for Private Onsite Wastewater Systems VERSION 2.0" SBD-10691-P(N.01/01) <br /> and the"Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems VERSION <br /> 2.0" SBD-10706-P(N.01/01). <br /> • In the event this soil absorption system or any of its component parts malfunctions so as to create a health <br /> hazard,the property owner must follow the contingency plan as described in the approved plans.The owner <br /> must insure that the operation,maintenance and monitoring duties as described in section VIII of the mound <br /> manual,and section VI of the pressure distribution component manual are complied with.A copy of this letter <br /> including instructions and information regarding proper use and maintenance of the system must be <br /> given to the owner and each subsequent owner upon completion of the project. <br /> • A state approved effluent filter is required.Maintenance information must be given to the owner of the tank <br /> explaining that periodic cleaning of the filter is required.Access to the filter for cleaning must be provided <br /> per Comm 84 product approval conditions. <br /> • A Sanitary Permit must be obtained from the county where this project is located in accordance with the <br /> requirements of Sec. 145.135 and 145.19,Wis. Stats. <br /> • Inspection of the private sewage system installation is required.Arrangements for inspection shall be made with <br /> the designated county official in accordance with the provisions of Sec. 145.20(2)(d),Wis. Stats. <br /> • Comm 83.52(3) The activities relating to evaluation and monitoring mechanical POWTS components after the <br /> initial installation of the POWTS in accordance with an approved management plan shall be conducted by a <br /> person who holds a registration issued by the department as a registered POWTS maintainer. <br />