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INFORMATION & INSTRUCTIONS FOR COMPLETING A SANITARY PERMIT <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 /> II. 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 41. 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 /> Vl. 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 a//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 given when application is disapproved. <br /> Complete plans and specificat�_c> not smailer than c'-� , 11 inches must be submitted to the co,iaty. The <br /> plan- m,,st include the following. a� oiot asap drawn to scale or with complete-dimension :: c, <br /> hold rg tankis; septic tanks' o- :ae- treatmen- Tanis; building sewers. weals. wale- mawate se'�rc <br /> Streams and iak95: dosm., or p::mp �^ cnamhers: distribut(o.^ boxes Seii ab crpbnn system,; 'e-'acPme^' <br /> system areas a-,d t`e le at :r r r h� �d;nc se-vec B. .horzonta ger' e av-' <br /> ,,* n 'erere- e <br /> C cum ,ete s eciflcanors to, n;, Ios anr controls d�se volume eieva+,inr n 'ferP:,r:es t �+ oma. to mr <br /> perforrna.ncs curve . r-r iT odel and Du e is cr� ac..ire, Di cress sec'.rbi� u' thr 11 <br /> requirec by the _ou _I sou Te-,, <br /> Un ill <br /> cumuwr. ,.V., . . _ ..'., _. <br /> result c! .� ` <br />