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JAMES P CROYSDALE Page 2 5/30/2017 <br /> Departmental Action:CONDITIONAL APPROVAL <br /> Reviewer's Conditions of Approval: <br /> • All of the petitioner's statements of fact or intent included on the variance application form,any other <br /> documents submitted to the Department,as well as any other conditions of approval listed below,shall be <br /> carried out. This variance is specific to the subject code section(s)petitioned and the building or object as it <br /> will exist following completion of the current construction project and shall not be used for any additional or <br /> future modifications,additions,or alterations to the subject building or object. <br /> This decision will become final unless the department within 30 days from the date of this letter receives a written <br /> request for a hearing. A request for hearing should be sent to the address shown on this letterhead. A copy of this <br /> letter must be included with the request for a hearing. The request for hearing should state the reasons for objecting <br /> to the department's decision,because a request for hearing may be denied if it does not present a significant question <br /> in fact,law or policy. <br /> Inquiries concerning this correspondence may be made to me at the telephone number listed below,or at the address <br /> on this letterhead. <br /> Sincerely, Fee Required$ 300.00 <br /> Fee Received$ 300.00 <br /> Yejor oeeedi Balance Due $ 0.00 <br /> Tim Vander Leest WiSMART code:7633 <br /> Private Sewage Plan Reviewer,Division of Industry Services <br /> (920)492-2214,Monday-Friday 6 am To 3:30 pm <br /> tim.vanderleest @wisconsin.gov <br />