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INSTRUCTIONS <br /> .. F, sanitary permit i� .�, ,. ,,, twa �2) years. <br /> '. Your sanitary permit may be renewed before the expiration date. and at the time of renewal any new <br /> criteria in the Wisconsin Adm!mstrat!ve Cede v:ill ba apphcab!e- <br /> All revisions to this permit roust be. approved by the permit issuing authority. <br /> 4. Char_es in ownership or plumber requires a Sanitary Permit Transtpr/Renewal Form (SBD 6359; to be <br /> submitted to the county prior to installation. <br /> Onsite sewage systems must he properly maintained The septic tank(s; must he pumped by a lica^sed <br /> pumper whenever necessary, usually every 2 to 3 year,. <br /> 6. If yen have questions concerning your onsite sewage system, contact your local code administrator or the <br /> State of Wisconsin, Safety & Buildings Division, 608-2663815. <br /> To be complete and accurate this sanitary permit application must include <br /> Property owner's name and mailm', address Gr^Vick, the legal desc--on and parcel tax number(s` o* <br /> where the sys`.em is to be installed <br /> 11. Type of building being served. Check only one and complete # of bearoomi, if 1 or 2 Family Dwelling. <br /> if 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 it permit is for tank replacement. reconnection, or <br /> repair. <br /> V Type of system. Check appropnate box depending on system type. <br /> V! Absorption system information. Provide af informatics requested in #1 T. <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 8%: 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, 13) 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(R.11186) <br />