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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: It 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 systemcheck 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 manufacturers 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 /> VII{. 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 specificatiore no' smaller than 8'-_ = '1 inches must be submitted to the count} —n , <br /> plans must include the following AI plot Plan drawn to scale or with complete dimensions, o,;aba•, v, <br /> holding tank's). septi, tank(s' o, the., t eabr:ent tanks b,iilding sewers. we'lC, wc:ter ma,nsrwater service <br /> streams and lakes dosing or pumping chambers dnstnbuticr boxes sot' ibscrp roc systems" rep'aceme^ <br /> system areas i.d ,- serve- B; nor z,1--ta and vert'gid' eleva'to­ eferert , ani nrs. <br /> n <br /> C1 cim�PIE. �par;ifications for pt,'Dnp and controls dose volume eievatior dl'+erenses frwt,o- lost. ppm^ <br /> performance curve ;uf-L. mude� dnu o rr ., ••id-,,'ae:urer, D; cross _section v4 thi, <br /> requ red by ^ne o..^ty; E, su test .-.e _ a - ,c 'crn-.. <br /> On play „ .a..; .15 <br />