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2008/07/01 - SANITARY - SAN - Other
Burnett-County
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TOWN OF UNION
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25390
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2008/07/01 - SANITARY - SAN - Other
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Entry Properties
Last modified
3/5/2020 2:42:07 PM
Creation date
9/29/2017 7:41:05 PM
Metadata
Fields
Template:
Property Files v2
Document Date
7/1/2008
Document Type 1
SANITARY
Document Type 2
SAN
Document Type 3
Other
Tax ID
25390
Pin Number
07-036-2-40-17-25-5 15-080-014000
Legacy Pin
036902501400
Municipality
TOWN OF UNION
Owner Name
CDM PROPERTIES LLC
Property Address
27826 YELLOW LAKE RD
City
DANBURY
State
WI
Zip
54830
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INSTRUCTIONS <br /> 1_ A sanitary perrnit is valid for two (2) years. <br /> Y i. sanitary Permit mut -,e r_ +.e . „ , " F .,gip• c :, 'r <br /> aQ <br /> a' ,r-:e (?r�ewal any new <br /> cnrerta m the Wisccns i Adr ,1,s! tlllje 0bad .uilhe dpp able. <br /> A ev!s'ons to 11"(s pe'r,t m,i,,.r. 'je approvea by the permit issuing <br /> 4- Changes in ownership or plumber requires a ,Sanitary Perm;t Transfer Renewal Form (SBD 6399) to be <br /> submitted to the county prior to ;installation, <br /> `;. Onsite sewage systems must be broper!y maintained. The 1,;ep11: (,4rkl l must be pumped by a i-ceased <br /> Pumper whenever necessary, usually every 2 to 3 years- <br /> 6. If you have questions concerning your onsite sewage system, contact your local code administrator or the <br /> —$tate of Wisconsin, Safety & Buildings Division, 608-266-3815. <br /> To be complete and accurate this sanitary permit application must include: <br /> I. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of <br /> where the system is to be installed. <br /> II. Type of building being served. Check only one and complete # of bedrooms if 1 or 2 Family Dwelling. <br /> III. Building use. If building type is Public, check all appropriate boxes that apply. <br /> IV. Type of permit. Check only one in line A. Complete line B if permit is for tank replacement, reconnection, or <br /> repair. <br /> V. Type of system. Check appropriate box depending on system type. <br /> VI. Absorption system information. Provide all information requested in ##1-7. <br /> VII. Tank information. Fill in the capacity of every new and/or existing tank, list the total gallons, number of <br /> tanks and manufacturer's name. Indicate prefab or site constructed and tank material. Complete for a// <br /> septic, pump/siphon and holding tanks for this system. Check experimental approval only if tanks received <br /> experimental product approval from DILHR. <br /> VIII. Responsibility statement. Installing plumber is to fill in name, license number with appropriate prefix (e.g. <br /> MP, etc.), address and phone number. Plumber must sign application form. <br /> IX. County/Department Use Only. <br /> X. County/Department Use Only. <br /> Complete plans and specifications not smaller than 8f F 11 inches must be submitted to the county. The <br /> plans must include the following. A) plot plan, drawn 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 /> streams and lakes, pump or siphon tanks; distribution boxes; soil absorption systems; replacement system <br /> areas, and the location of the building served; B) horizontal and vertical elevation re'erence points; <br /> C) complete specifications for pumps and controls: dose volume; elevation differences; friction loss; pump <br /> performance curve; pump model and pump manufacturer; D) cross section of the soi absorption system if <br /> required by the county, E) soil test data on a 115 form, and F) all sizing information. <br /> GROUNDWATER SURCHARGE <br /> 1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of <br /> regulated practices which can effect groundwater. <br /> The monies collected through these surcharges are used for monitoring groundwater, ground- <br /> water contamination investigations and establishment of standards. <br /> SBD-6398(R.11/88) <br />
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