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INSTPUCTIONS <br /> 1 sanitary permit is vai d for two (2) years <br /> 2 Your sanitary per nil n il: h,: J1, eY.,11,,i3ior date an at the time of renewal an, new <br /> cfnie6a in the Yi.arori, fr A,-'r,.imsirative Code will be applicable. <br /> 3. All revisions to this permit must be approved by the permit issuing authority. <br /> 4 <br /> Changes in ownership -,r plumber requires a Sanitary Permit Transter,'Renewal Form (SBD 6399) to be <br /> submitted to the county prior to installation <br /> 5 Onsite sewage systems must be properly maintained. The septic tank(s) must be pumped by a licensed- <br /> pumper <br /> icensedpumper whenever necessary, usually every 2 to 3 years. <br /> 6. If you have questions concQ.rni.ng your onsi <br /> I tp sewage system, contact your local code aaministrator or the <br /> State of Wisconsin, Safety & BtAldingsh sion, 608-266-3815. <br /> To be complete and accurate this sanitary pelrmit 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 /> II. Type of building being served. Check only one and complete # of bedrooms if 1 or 2 Family Dwelling. <br /> 111. Building use. If building type is Public, check all appropriate boxes that apply. <br /> IV. Type of permit. Check only one in line A. Complete line 6 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, list the total gallons, number of <br /> tanks and manufacturer's name. Indicate prefab or site constructed and tank material. Complete for all <br /> septic, pump/siphon and holding tanks for this system. 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.), 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 8% 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) horizontal and vertical elevation reference points; <br /> C) complete specifications for pumps and controls; dose volume; elevation differences; <br /> friction loss; pump <br /> performance curve, pump modal 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) a14 sizing information- <br /> --------------—------------------------——-------------------------------------------------------------------------------------------- <br /> GROUNDWAT611'SURCHAROIE <br /> 1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of <br /> regulated practices which can effect groundwater. <br /> The montes collected through the'se surcharges are used for,monitoring groundwater, ground- <br /> water contamination investigations ane establishment of-standirds. <br /> S130-6398 fid-11/88) <br />