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Safety and Buildings <br /> 10541N RANCH ROAD <br /> HAYWARD WI 54843 <br /> TDD#:e.sta 264-8777.us/s <br /> isconsin www.ccmmerce.state.vA.us/sb <br /> onsin.gov <br /> www.wisconsin.gov <br /> Depari.ment of Commerce Scott McCallum,Governor <br /> Philip Edw.Albert,Secretary <br /> March 11,2002 <br /> CUST ID No.227691 ATTN: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 AT 54872 SIREN WI 54872 <br /> CONDITIONAL APPROVAL Identification Numbers <br /> PLAN APPROVAL EXPIRES: 03/11/2004 Transaction ID No.711314 <br /> SITE: Site ID No.641816 <br /> Judy Rodgers Please refer to both identification numbers, <br /> Hwy 70 above,in all correspondence with the agency. <br /> Town of Sand Lake <br /> Burnett County <br /> Government Lot(s)6,S32,T39N,R15W <br /> Lot: 1, <br /> FOR: <br /> Description:Inground Non-Pressurized 190 Gpd. <br /> Object Type:POWT System Regulated Object ID No.: 831682 <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 /> Correspondence Notes: <br /> • This plan action is subject to designer notes/comments on the plan. <br /> • This system is to be constructed and located in accordance with the enclosed approved plans and with the <br /> "Component Manual,SBD-10567-P(R.6/99)".In the future identify the Component Manual on the <br /> Index of your submittal used in the design of all POWTS. <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 Coll <br /> review shall relieve the designer of the responsibility for designing a safe building,structure,or component. 1 <br /> Inquiries concerning this correspondence may be made to me at the telephone number listed below,or at the addressV. <br /> on this letterhead. P <br /> The above left addressee shall provide a copy of this letter to the owner and any others who are responsible for the V `� <br /> installation,operation or maintenance of the POWTS. <br /> S' <br />