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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 #1. 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 /> 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 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 resaor given when application is disapproved. <br /> Complete pians aad specification's no` smaller than 6',_1 > 11 inches mus' be subrlJtted to file County Tr,s <br /> planss must netude the follow�'ng A' plot plan, drawn to scale or with, complete dimensions. ''ocafor, oP <br /> hold ng tank'st. septic tanks o, Mhe, ,reatr, -n' ,a^.is. b .i;d,nu sewers we'!. water rrrains.'wafer mer,; e <br /> streams and lakes dosing or pu^'p 'o chamners dls±rrbutnor boxes- cot' abs rprior sA,q'e,, re,�aoemen <br /> system areas a1 ,h = lo-„er 'he Du J,- , se,vec B. nor zonta' -ere.e.r.e <br /> '.` COrr,p ele specifications for pi.e_o-e ano cortrole709e vnIUMC ele\abor �ifferen CeS `nrtr IOss n'_rrrn <br /> performance cur,,e - ', ,'node! am o-,* ,, ar.aaC-.,,e , cress sectloro+ the <br /> require,' by the sz :e;' .. ._e - _ _ rorr- <br />