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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) year,
<br /> 2. Your sanitary permit may be renr,'wed before the expiration date, and at the time of renewal any new
<br /> criteria in the Wisconsin Administrative Code will be applicable.
<br /> All revisions to [vis perm r r r.s! ue app `:cit r_,v Ine per!, i suing auth,--t, " new per ! n ay be it coc c,
<br /> iE th—e is a cha,ge m you b i id ng ,,_ai a. cystici, r:3t, nsnmated wastewater flow i- .mbt : o` bec-
<br /> !oorrs, etc_i_ depth u° system. w `ypr a` spsrer
<br /> °,ubmlttec to the o,!ty Fri i t st"
<br /> orva,�. sc•.ro.ge _ 7 6 br- p-ri,N.... .,y r
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<br /> A!,J u 'Lf app! _a il)�. Che.= o; ^i`e Irl to rani 'e4 a: emL 'r-GnreO ioi, Lir
<br /> cepa ..
<br /> `ypr, of .system: r_heck all ap;rop.iate boxes .rep, rd-ng system. type_ ChecK experimental only it project
<br /> is In conjunction with University of Wisconsin.
<br /> V. Absorption system information: Provide all information requested in #1-B,
<br /> VI_ Tank information. Fill in the capacity of every new and/or existing tank, list the total gallons to be installed,
<br /> nomber of tanks and manufacturer's name. Indicate prefab or site constructed and tank material. Complete
<br /> for all septic, lift!slphon 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 p!umberts to fill n name, license number with appropriate prefix fe.g.
<br /> MP, etc.), address and phone number. Plumber must sign application form. Fill in designer name if
<br /> applicable,
<br /> V!1. Soil test information. Ce,tifie soil testers name cert ficatior iur*mbe, address, and phone nrmber.
<br /> iX. County/Department use Oniy
<br /> X Cornment area for use by co.inty a: iesaon given when appli-aton is disapproved
<br /> Complete pians and speelficators nc smalier than `_ - 1'. riches must be submitted to he oaa'y Thr
<br /> pians must include the. following Al clot pian, drawr ;e scale or with complete dimensionslocates o`
<br /> holding tank(s), septic tar�k!sor other treatment ranks, buiiding sewers, wells, water mains!water service.
<br /> streams and lakes, dosing or pumping chambersdistribution boxes, soil absorption systems: replacement
<br /> system areas, and the Irca6on " the Tui ding se"ve:' R; horrzon;al anal vertloal elevation refe-ence points
<br /> C) cornplete specifications for pumps and controls. oose volume; elevation differences, friction loss, purne
<br /> performance curve; pum, model and purne n-:ai 'acture. D. cross section of the soli abs—pt on system i`
<br /> required by the county. ET soil test alta on a 115 iorn
<br /> GRCrJNC:G JIiATEi•- SURCr+ARGE
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