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INSTRUCTIONS <br /> .. F. satr;tary permit is valid for two (2/ year. <br /> 2. Your sanitary permit may be renewed before the expiration date, and at the time of renewal any new <br /> critena in the Wisconsin Administrative Code wit! be applicable. <br /> All revisions to this permit must be approved by the permit issuing authority. <br /> 4. Changes in ownership or plumber requires a Sanitary Permit ransfer/Renewal Form (SBD 6399) to be <br /> submitted to the county:prior to installation <br /> 5 Onsite sewage systems must br. prope-ly maintained. The septic tami(s) must be pumped by alicensed <br /> pompe: wl'ra.,ever Necessary snally dvLry is yeats. <br /> 6. If you have questions concerning your onsite sewage system, contact your local code administrator or the <br /> S[_te of Wiscnnsin. Safety & Buddings Division EO?266-3815 <br /> To be complete and.accurate this sanitary permit application must include: <br /> i Property owner's name and mailing address. Prov de 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 Dwelting. <br /> III. Building use. it 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 at information requested in #1-7. <br /> VII- Tank information. Fill in the capacity of every new end/or existing tank, list the total gallons, number of <br /> tanks and manufacturer's name. Indicate prefator site constructed and tank material. Complete for all <br /> septic, pump/siphon and holding tanks for this syslern. Check experimental approval only if tanks received <br /> experimental product approval from DILHR. <br /> VIII. Responsibility statement. Installing plumber is to fi'I 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 8'h x 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 reference 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 soil absorption system if <br /> required by the county; E) soil test data on a 115 form, and F) all sizing information. <br /> -------------------------------------------------------------------------------------------------------------------------------------------------------- <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 in.11/88,` <br />