Laserfiche WebLink
INSTRUCTIONS <br /> 1. A sanitary pei mit is valid for two (2) years <br /> 2. Your sa!(tary permit may be rerewci' t•efc c w e:p _r a,,t:c. ir,d -r: tI c t.n,e _;f r�ewat anv new <br /> Gr-deria Io the W,I'cons❑, ve Co Jr, w-ii be appi,__U Lv <br /> Alt c sia,s to this per , I mus- a}%orovru by iht pc mi issuwg ac[Piorrty. <br /> C. Changes it ownership n7nir;mrn. -equirec a Sa^ tar• nr ,i t r - tpr R;�aewal rc, (SBD r'l99) to be <br /> submitted to the county prior to nsta labor.. - <br /> 5. Onsite sewage systems must be p*cperiy m *a Med 7h� se(•tS ,��r.•.s; —L!st be pumped by a lice^sed <br /> pumper whenever necessary, _sual!y every 2 to I years <br /> F. if you have questions concerning your onsite sewage system, contact your local code adm•nistrator or the <br /> State of Wisconsin, Safety & Buildings Division, 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 and parcel tax number(s) of <br /> where the system is to be installed. <br /> ll. Type of building being served. Check only one and complete # of bedrooms if 1 or 2 Family Dwelling. <br /> III. Building use. It building type is Public, check all appropriate boxes that apply. <br /> IV. Type of permit. Check only one in line A. Complete line B if permit is for tank replacement, reconnection, or <br /> repair. <br /> V. Type of system. Check appropriate box depending on system type. <br /> VI. Absorption system information. Provide all information requested in #1-7. <br /> VII. Tank information. Fill in the capacity of every new and/or existing tank, !ist 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 ;his systerr. 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.1, 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 8i2 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; B) horizonta:' and vertical elevation reference points; <br /> C) complete specifications for pumps and controls; dose volume; elevation differences; friction !oss; 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 /> 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.111/88) <br />