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9CpARTA1FH Safety and Buildings <br /> �y3 To 10541N RANCH ROAD <br /> HAYWARD WI 54843 <br /> 3 ` Contact Through Relay <br /> www.dsps.wi.gov/sb/ <br /> X20 4 $,.�� www.wisconsin.gov <br /> �Ossio` N Scott Walker,Governor <br /> Dave Ross,Secretary <br /> December 03,2012 <br /> CUST ID No. 227691 AT71V:POWTS Inspector <br /> ZONING OFFICE <br /> WADE A RUFSHOLM BURNETT COUNTY SPIA <br /> 24702 LIND RD PO BOX 514 7410 CTH K#102 <br /> SIREN WI 54872 SIREN WI 54872 <br /> CONDITIONAL APPROVAL <br /> PLAN APPROVAL EXPIRES: 12/03/2014 Identification Numbers <br /> Transaction ID No.2179296 <br /> SITE: Site ID No. 786440 <br /> Kurt Belk Please refer to both identification numbers, <br /> 28930 Bobcat Ln above,in all correspondence with theagency. <br /> Town of Jackson <br /> Burnett County <br /> , S7,T40N,R15 W <br /> Lot:2, <br /> FOR: <br /> Description:Mound, 1-2 bedroom cabin& 1-1 bedroom cabin <br /> Object Type:POWTS Component Manual Regulated Object ID No.: 1403953 P <br /> Maintenance required; Replacement system; 450 GPD Flow rate; 33 in Soil minimum depth to limiting factor from COM <br /> original grade; System(s):Mound Component Manual-Version 2.0, SBD-10691-P(N.01/01),Pressure Distribution <br /> Component Manual-Version 2.0, SBD-10706-P(N.OI/Ol), SSWMP Pub.9.6; Effluent Filter APP P <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 system is to be constructed DIVISION OF) <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 101.01(10),Wisconsin Statutes,is responsible for compliance with all code — <br /> requirements. SEE COI <br /> No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, <br /> stats. <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,the <br /> owner must insure that the operation,maintenance and monitoring duties as described in section VIII of the <br /> mound component manual are complied with.A copy of this information must be given to the owner upon <br /> completion of the project. <br /> • Care must be taken to preserve the bench mark during construction or establish a new bench mark with the <br /> elevation set to relate to the original bench mark. <br /> Reminder <br /> • The float switch shall be a type that does not contain mercury.2009 Wisconsin Act 44 prohibits the installation <br /> of float switches or relays that contain mercury. <br /> • The designer proposes to install a state approved effluent filter to achieve the requirement of wastewater particle <br /> size. Pursuant to outlet filter product approval stipulations,maintenance information must be given to the owner <br /> of the POWTS explaining that periodic cleaning of the effluent filter is required. The access opening used to <br /> service the filter shall terminate at or above finished grade with a watertight cover. <br />