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INFORMATION & INSTRUCTIONS FOR COMPLETING A SANITARY PERM IT
<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 /> criteria in the Wisconsin Administrative Code will be applicable;
<br /> 3. All revisions to this permit must be approved by the permit issuing authority. A new permit may be needed
<br /> if there is a change in your building plans, system location, estimated wastewater flow (number of bed-
<br /> rooms, etc.), depth of system, or type of system;
<br /> 4. Changes in ownership or plumber requires a Sanitary Permit Transfer/Renewal Form (SBD 6399) to be
<br /> submitted to the county prior to installation;
<br /> 5. Private sewage systems must be properly maintained. The septic tank(s) should be pumped by a licensed
<br /> pumper whenever necessary, usually every 2 to 3 years,
<br /> 6. If you have questions concerning your private sewage system, contact your local code administrator or the
<br /> State of Wisconsin, Bureau of Plumbing, 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 where the system is to be
<br /> installed;
<br /> IL Type of building or use served: If public is checked, indicate type of use (i.e. 10 unit apartment, 30 seat
<br /> restaurant, etc.). Fill in number of bedrooms if building is a one or two family dwelling;
<br /> III. Purpose of application: Check only one in #1. Complete ##2 if permit is for tank replacement, reconnection or
<br /> repair;
<br /> IV. Type of system: check all appropriate boxes depending on system type. Check experimental only if project
<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 manufacturer's name. Indicate prefab or site constructed and tank material. Complete
<br /> for all septic, lift/siphon chamber and holding tanks for this system. Check experimental approval only if
<br /> tanks received experimental product approval from DILHR;
<br /> VII. 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. Fill in designer name if
<br /> applicable;
<br /> VIII. Soil test information: Certified soil tester's name, certification number, address, and phone number.
<br /> IX. County/Department Use Only,
<br /> X. Comment area for use by county or resaon giver when application is disapproved.
<br /> Complete plans and specifications no' smalle- than r , , 11 inches must be submitted tc the county The
<br /> plans must include the follow'nu A'; plot pian. drawn to scale or with complete dimens,ur,s ,ratio^ of
<br /> holding tank(s), septic tanks: o- -,tho- treatmen' !ants. building sewe s well water -nw-s'wate: st!, .ce
<br /> streams and lakes, dost',, 01 cnafnbers dis!,ibutior boxes- so,� absorp'ion sysfems rep'a^eme
<br /> system areas. a � —e (:--,at '.ilr b„ e B; ,or znra '• c %er- .a elevate,o � �ererer,
<br /> C; complete specifications +or pr.n,p�. am cont ors��7ose volume. elevation inferences ft �!,C, los n . r
<br /> performance curve - , rr,de: anu trer�
<br /> requr-ed by the sc te,;r na a
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