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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 /> Your sanitary permit may be ren?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 tc r`rss pemYl must be a{,pr.,,eo .iy the per r , thouity r,e:v pe,:it may b rs_d.
<br /> 'f thsre s a charge In yo, builC! ,)la -. sys e n. Ieeati rnn'.11 wasteor ater flow r cf be'
<br /> rooms, etc.), depth of system, m type of syserr-
<br /> Che r= in �w� F ;: c, ; I,. n[a. cs .. Sa :aa, r ,. sie.'Re"rev r�-n• ("1 F^,3�'
<br /> ss,brnitted to the (:ounty u,ior tc Iiait
<br /> �. Pr!VatP ,ewE.g� ys „�, b:. N:eNc-. :ria ,r, ,,e:: _ .0 Jh-_ d be
<br /> rest.l t _ ether rr r ,rims nui;(iin;; s a u .e. or (wo tal ow, 'in-i .
<br /> I'I. Purpuse of application. `„geek un'. e ut #r. ,on y.iute g-) n permit is for tanr replacer a i. !eron ,eC' a.
<br /> repair,
<br /> !V- Type of systemcheck all appropriate boxes iPpendirg on system, type. Checrc 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 ie-g.
<br /> MP, etc-), address and phone number- Piumber must sign application form. FIII in designer name If
<br /> applicable,
<br /> VIII_ Soil test information Certified soil tester's name, certlfication 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 specifications not sna!le- than 3'. 11 '.riches must be submitted to the soucty. Thr
<br /> plans must include the following. A) plot plan, drawn to scale or with complete dimensions, location of
<br /> holding tanl septic tank(s,. or other treatment tanks, building sewers. wellswater mains/water service
<br /> streams and lakes. dosing or pumping cnarnbers distribution boxes. soil adsorption systems replacement
<br /> system areas: and the location o' the buwiding served. Bi horizontal and vertical e,'evation reference points-
<br /> C) complete specifications for pumps and controlsdose volume, elevation differences: friction loss pump
<br /> performance curvepump model and pump manufadurer, D' cross section of the sol' ab _rpton syste:rr. ..
<br /> required by the county, E) sell! test data on a 115 form
<br /> GROUNDWATEr. SDRCkARGE. r
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