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Safety and Buildings <br /> 10541 N RANCH ROAD <br /> HAYWARD WI 54843 <br /> TDD#:(608)264-8777 <br /> Nvisconsin www.commerce.state.wi.us/sb <br /> Department of Commerce www.wisconsin.gov <br /> Jim Doyle,Governor <br /> Cory L.Nettles,Secretary <br /> October 29,2003 <br /> CUST ID No.232076 AITN.•POWTS Inspector <br /> ZONING OFFICE <br /> MARTY S SWERKSTROM BURNETT COUNTY SPIA <br /> PO BOX 114 7410 CTH K#102 <br /> LUCK WI 54853 SIREN WI 54872 <br /> CONDITIONAL APPROVAL Identification Numbers <br /> PLAN APPROVAL EXPIRES: 10/29/2005 <br /> SITE: David Rudolph Transaction ID No.930877 <br /> 22268 Bergman Point Dr Site ID No.666941 <br /> Town of Trade Lake, 54840 Burnett County Please refer to both identification numbers, <br /> Government Lot(s) 1,S2,T3 7N,RI 8W above,in all correspondence with the agency.' <br /> FOR: Description:Holding Tank 200 gpd. <br /> Object Type:POWT System Regulated Object ID No.:926472 <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 /> 1. Comm 83.54(2),A water meter shall be installed by a properly licensed plumber,on the water system,that <br /> adequately measures the amount of water used by the structure,excluding hose bibs and wall hydrants,which <br /> do not discharge into the sanitary system. <br /> 2. Refer to the Holding Tank Component Manual,the management plan/users manual must contain the telephone <br /> numbers of persons to contact including the County Zoning Office,be sure to provide this information to the <br /> owner.If you are in need of additional information as to what constitutes a"Users Manual'please contact this <br /> office. <br /> • Comm 84.10,All materials used in this installation shall conform to the provisions of this chapter. <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. Q O <br /> The above left addressee shall provide a copy of this letter to the owner and any others who are responsible for the � <br /> yti <br /> installation,operation or tenance of the POWTS. <br /> Since Fee Required$ 60.00 <br /> �J Fee Received$ 60.00 V� <br /> C e , a w v Balance Due $ 0.00 <br /> Thomas EDevereaux / <br /> Plumbing/POWTS Reviewer II,Integrated Services <br /> (715)634-3026,7:15 am-4:00 pm Mon.-Fri. WiSMAR T code.7¢33A <br /> tdevereaux@commerce.state.wi.us <br /> cc: Carl J Lippert,Wastewater Specialist,(715)634-3484 <br />