HomeMy WebLinkAboutLetter-Cross Connection Control)
APR-20-2007 01:10 PM
P.02/03
~ commerce.wl.gov
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Safely and8ulldlngs
PO BOX 7162
MADISON WI 63707-7162
TOD #: (60B) 264-B777
www.commerce.wLgov/sb/
www.wlsoonsin.gov
Jim Doyle, Governor
.Mllry P. Burke, Becretilry
April 17, 2007
CUST ID No. 901232
US BANK
111 N MAIN ST
OSHKOSH WI 54901
CROSS CONNeCTION CONTROL ASSEMBLY
REGISTRATION
ARNOLD F HENKE
520 W SOUTHPARK AVE
OSHKOSH WI 54902
SITE';"""""
Us Bank
111 N Main
City of Oshkosh, 54901
FOR:
Object Type: Cross Connection Control Device Regulated Object ID No.: 1127137
Device Js Serving: BOILER CHILLER; Device Type: Reduced Pressure Preventer: Looation on Property:
BOILER ROOM 6tH FLOOR; Manufacturer: WATTS; Model: 909M~QT; Serial No.: 25371; 1" Valve Size
Identification Numbers
Transaction 10 No. 1387024
Site 10 No. 649357
Please refer to both identification
numbers, above, In all correspondence
. with the aaenoy.
Per your request the device(s) described above has been REGISTERED with our agency, In lieu of plan
review by our agency. As owner of this building, you should understand:
1. That there will be no review of the installation plans for this project conduoted by the Department of
Commerce.
2. That there will be no routine inspections conducted by the Department of Commercedurrng the
Installation of this project.
3. That plan review and/or inspections by the local municipality may be required by local permitting
ordinances.
4. That this registration does not affect the requirements to submit plans for building systems, plumbing
systems, private sewage systems, swimming pools, elevators or other plans If applicable.
5. That upon completion of construction. this Installation shall be in compliance with all applicable
Wisconsin codes and standards.
6. That as the owner, you are responsible to assure that a performance test is oonducted for the above
assemblies at the time of installation, immediately after repairs or alteration to the assembly and at
least annually.
:i7)' ::::t'M <iroSis:~6tinrisi~li-ot):'~Q'H:tj;Q'I':ass9mbll~s'ln didatEitl hl:'tl:ieabov.ebesCrlption'b@xit!iave 'b'e'en~ir:e9'i$tered
~:::,:.';:r:;1jfVi,th:.:tb~j:~~pA~~~rt(,:;:;IS~p~l:'~,..v.j6l?j:i~ha:lil:t>.~ J~I!i'g~dias'p~r :9~mm:'~.2~4PX~Hg:)~;'~~~h.d~Vi~~,'~h~n,~~. .,:'.
:,.::':"~teste~!:M:(Loopbifu:id}a;$,~pl:ir;;iG$itim' ;e2,.2~',(3J:'iC6h_ci:'MaterJa:1 :,Craer:s,:at:eQa~2'6:6~g78a:,f,Cil:r..:a,:,&i.ipP'I~:()f '.
':'!:~~+7;i!,ta~s:pr;!~~'Hi)~iri~~~6j~~~~:~f:apro$;,::'::~!:X!:::J::!::.i'::::."i(i!":::i:;:/.:::::::>: </ ,.1,:;::':::: .:'::;: ,;:,,\./ /.' ::~'.>/,:i~!;;': ," :.' (<':i:'i:. ;:: :;;:- ~::": :.':.:!:::: ;':::' .
8. No 'person may engage in or work at plumbing In the state unless licensed to do so by the department
per 5.145.06 stats.
Prior fo the start of ~~>nstru9tion, all applicable plumbing permits should be obtained from the authorities
having Jurisdiction in aooordance with local laws andordlnancas..This registration is valid for the period
Indicated above. Thereafter. the unfinished portions of the project shall be redesigned to the code existing
at that time and shall be re-reglstered with our agency. .
APR-20-2007 01 :11 PM
US BANK
Pa~>e 2
411 7/2007
P.03/03
Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at
the address on this letterhead. Plasse refer to the Transaction 10 No. referrl)d to In the regarding line
when mal<lngan inquiry or submitting additional information.
Sincerely. . ., ___)'
UYu~~-O~
Christine Severson
Program Assistant I Integrated Services
(608)267-2497 I 7:30 To 16:00
christine.severson@wisconsin.gov
cc: Municipal Clerk City of Oshkosh, 920/236-5011
Fee Required $
Fee Reoeived $
Balance Due $
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frf.V.i ,~,I\fi.. 'rJ; r: :;.,~\:.t,~.' '{:',' ",:1
125.00
, 25.00
0.00