Laserfiche WebLink
INFORMATION & INSTRUCTIONS FOR COMPLETING A SANITARY PERMIT <br /> APPLICATION <br /> TO THE APPLICANT: <br /> 1. This sanitary permit is valid for two (2) years:. <br /> 2 Your sanitary permit may be renewed before the expiration date, and at the time of renewal any new <br /> c•iteria in the Wisconsin Administrative Code will be applicable, <br /> AIl reVJ5?0nS to this Perri mus' be approved by the per f,t suing authority A new permit may nced:,, <br /> if thr.re ,s a change ;n you- build'ng pars sys tc , ,:::at e.-timate-1 wastewater flow (nurnbe- e' bec- <br /> rooms, etc.). depth of system or type of sysien <br /> r. aiwnr ;F:p u1 pl�mu. "euw�e� a 1 .a: r', ons'u hR, rw,, SBC 6'99 <br /> submitted to the county prior tostallation. <br /> rlcato systcrn-s t,., b" properly ma i`.: eG. - - ..,.., 'o " c: ahG-ld be pump..- <br /> i. Jmner ii `.L -OpmS 1 bu CI ,v J r r N., fa rirl'� w 'rtV' <br /> P it p ,,c of ap{, .:,e Iia Check onl) one in #i. Con piece 4z if perni�t .s to, ianr ekzcer re n. recur tcctlon or <br /> repair. <br /> lV. Type of system_ check all appropriate boxes depending on system type- Check experimental only if protect <br /> is in conjunction with University of Wisconsin, <br /> V_ Absorption system information: Provide all information requested in #1-6', <br /> VI. Tank information. Fill in the capacity of every new and/or existing tank, list the total gallons to be Installed, <br /> number of tanks and manufacturers nameindicate prefab or site constructed and tank material. Complete <br /> for a//septic. lift'siphon chamber and holding tanks for this system. Check experimental approval only if <br /> tanks received experimental product approval from DiLHH; <br /> Vll_ Responsibility statement Installing plumber Is to fill in name, license number with appropriate prefix (eg_ <br /> MP, etc.), address and phone number. Plumber must sign application form. Fill in designer name if <br /> applicable, <br /> VIII. Soil test information Certified soil testers namecertification number, address, and phone number. <br /> IX. County/Department Use Only; <br /> XX. Comment area for use by county or resaon given when application is disapproved <br /> Complete plans and specifications not smaller than 3':5 , 11 !nches must be submitted to the county. The <br /> plans must include the following- A) plot plandrawn to scale or with complete dimensions, location of <br /> holding tank(s), septic tank(s; or other treatment tanks.. building sewers, wells: water mains/water service <br /> - <br /> streams and lakes, dosing or purnping chambersdistribution boxessort absorption systems; replacement <br /> system areas, and the location o` the building serves B) horizontal and vertical elevation reference points. <br /> C) comp!ete specifications for pumps and controlsdose volume; elevation differences, friction loss: pump <br /> performance curve; pump model and pump manufacturer, D) cross section of the soif absorption system If <br /> required by the county: E) soil test data on a 115 forrc <br /> GROUNDWATER: SURCHARGE <br /> J :4. i V. YY IJV V��: -.`. .. � �v'_�i�� ... i �Y. -- .e�.� .. rr F <br /> Hadi <br /> i <br /> k t .. <br />