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INSTRUCTIONS <br /> 1. A sanitary permit is valid for two(2)years- <br /> 2 Your sanitary permit may be renewed before the expiration date,and at a time of renewal any new criteria in the <br /> Wisconsin Administrative Code will be applicable. <br /> 3 All revisions to this permit must be approved by the permit issuing authority. <br /> 4 Changes in ownership or plumber requires a Sanitary Permit Transfer/Renewal Form (SBD-6399) to be submitted to the <br /> county prior to installation <br /> Onsite sewage systems must be properly maintained The sepL;ctank(s; must be pumped by a licensed purmet vvhenelje° <br /> necessary, usually every 2 to 3 years. <br /> If you have questions concerning your oruite sewage system, contact ycur local code administrator or the State rr <br /> Wisconsin,Safety and Buildings Division. 608-266-3815. <br /> To be complete and accurate this sanitary permit application must include: <br /> 1 Property owner's name and mailing address. Provide the legal descr,ption and parcel tax number(s) of where the <br /> system is to be installed <br /> i. Type of building being served- Check only one and complete # of bedrooms i i 1 or 2 Family Dwelling <br /> M Building use. If building type is public, check all appropriate boxes that apply <br /> - <br /> !V. Type of permit. Check only one on line A Complete line B if permit is for tank replacement, reconnection, or repair. <br /> V Type of system. Check appropriate box depending on system type. <br /> VI. Absorption system information. Provide all information requested for numbers 1 through ;- <br /> VII. Tank information. Fill it the capacity of every ne%,v/or existing tank, list the total gallons, number of tanks and <br /> manufacturer's name, indicate prefab or site constructed and tank material_ Complete for all septic, pump/siphon and <br /> holding tanks for this system. Check experimental approval only if tanks received experimental product approval from <br /> DILHR. <br /> VIII. Responsibility statement- Installing plumber is to fill in name, license number with appropriate prefix (e.g- MP, etc.), <br /> 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 li2 x 11 inches must be submitted to the county The pians must <br /> include the following: A) plot'plan,drawn to scale or with complete dimensions, location of holding tank(s),septic <br /> tank(s) or other treatment tanks; building sewers; wells, water mainsiwater service; streams and lakes; pump or siphon <br /> tanks; distribution boxes, soil absorption systems; replacement system areas; and the location of the building served; <br /> B;. her!zontal and vertical elevation reference points; C) complete specifications for pumps and controls, dose volume, <br /> elevation differences; friction loss; pump performance curve; pump model and pump manufacturer, D) cross section <br /> of the soil absorption system if 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 mciuded the creation of surcharges(fees? for;I n,.-nber of regulated practices which car <br /> effect groundwater <br /> 1 , ... 'dwaier Co tam,.`,ati onin �eSt'Qat '1 r, <br /> v,nd estab shn-eni ^`standar(k <br />