2002/05/22 - SANITARY - SAN - Other

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Safety and Buildings 10541 N RANCH ROAD HAYWARD WI 54843 Ivisconsin TDD#: .sta 264 us/sb www.commerce.state.wi.us/sb onsin.gov www.wisconsin.gov Department of Commerce Scott McCallum,Governor Philip Edw.Albert,Secretary May 14,2002 CUST ID No.227691 A7TN:POWTS Inspector WADE A RUFSHOLM ZONING OFFICE 24702 LIND RD BURNETT COUNTY SPIA PO BOX 514 7410 CTH K#102 SIREN WI 54872 SIREN WI 54872 CONDITIONAL APPROVAL Identification Numbers 1P.0 PLAN APPROVAL EXPIRES:05/14/2004 Transaction ID No.732872 Colla Site ID No.644455 SITE: Please refer to both identification numbers, Brian Doolittle Assembly Rd above,in all correspondence with theagency. Ti� Town of Wood River Burnett County , Government Lot(s) 3,S34,T3 8N,R18W FOR: New holding tank,3 bed room residence -' SEE C Object Type:POWT System Regulated Object ID No.: 850832 The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner,as defined in chapter 101.01(10),Wisconsin Statutes,is responsible for compliance with all code requirements. The following conditions shall be met during construction or installation and prior to occupancy or use: General Approval Conditions: • This system is to be constructed and located in accordance with the enclosed approved plans and with the "Holding Tank Component Manual,SBD-1057 1-P(8.6/99)" • In the event this holding tank malfunctions so as to create a health hazard,the property owner must follow the contingency plan as described in the approved plans.In addition, the owner must insure that the operation, maintenance and monitoring duties as described the Holding Tank Component Manual are complied with.A copy of this information must be given to the owner upon completion of the project. • A Sanitary Permit must be obtained from the county where this project is located or other appropriate permit issuing agency in accordance with the requirements of Sec. 145.135 and 145.19,Wis.Stats. • Inspection of the private sewage system installation is required.Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d),Wis.Stats. • The maintenance plan for this system must be given to the owner of the POWTS. • Note: County regulations concerning the prohibition of holding tanks may vary. Check with the local permit issuing agency. • Note:The servicing of POWTS holding and treatment components,including septic tanks and holding tanks,is required to be performed by licensed pumpers under chs.NR 113 and NR 114. Review Notes • Manhole cover or service port to be no more than 25'from service road or drive per Holding Tank Manual, Table 1.