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2otpeartgyT DIVISION OF INDUSTRY SERVICES <br /> s (•",`1 10541N RANCH ROAD <br /> Ps�O x L. HAYWARDWI 54843 <br /> Contact Through Relay <br /> www,dsps.wi.gov/sbi <br /> p,a � www.wisconsin.gov <br /> �O�evmu� Scott Walker,Governor <br /> Dave Ross,Secretary <br /> December 12,2013 <br /> CUST ID No. 224059 A777✓..-PO TM Inspector <br /> KEITH E STONER ZONING OFFICE <br /> KEITH STONER SOIL TESTING SANITARY DESIGN BURNETT COUNTY SPIA <br /> 23220 WOOD CREEK RD 7410 CTH K 4102 <br /> SIREN WI 54872 SIREN WI 54872 <br /> CONDITIONAL APPROVAL <br /> PLAN APPROVAL EXPIRES: 12/122015 .Identification Numbersffs <br /> L <br /> Transaction ID No.2325303C <br /> SITE: Sne ID No. 740722 T <br /> Carl Bandt Please refer to both identification 27862 Leef Rd above, in all corres ondence wi"tTown ofJackson Burnett County /Government Lot(S)2,S26, T40N,R15WLot: 2, <br /> FOR:Description: Addition of aerobic treatment unit and wastewater flow change9 person maximum �typC <br /> Object Type:POWTS Component Manual Regulated Object ID No.: 1455265 <br /> Maintenance required; Replacement system; 675 GPD Flow rate; 73 in Soil minimum depth to limiting factor from <br /> original grade; Aerobic Treatment Unit,Effluent Filter,Miscellaneous Review <br /> . Please note: the fee is based on 3 hours of review time at$80.00 per hour. <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 s'stem 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 10 1.01(10),Wisconsin Statutes, is responsible for compliance with all code <br /> requirements. <br /> No person may enrage 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 /> • 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. In addition, <br /> the owner must insure that the operation,maintenance and monitoring duties as described in the '9n-Ground <br /> Soil Absorption Manual System"and the"Pressure Distribution Component Manual"and the management plan <br /> are complied with.A copy of this information must be given to the owner upon completion ofthe project. <br /> • This approval is for the addition of an aerobic treatment unit and is based on per capita sizing of 9 people <br /> maximum capacity. The dispersal cell has not been changed in anyway. A Flows and loads affidavit has been <br /> recorded with the deed. <br /> • The distribution cell is designed for wastewater strength with monthly averages of less than or equal to 20 <br /> mg/L of fall,oils and grease, less than or equal to 30 mg/L of biochemical oxygen demand and 30 mg/L total <br /> suspended solids and fecal coliform,levels of less than 10,000 cfu/100 ml. <br />