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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 /> !V. 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 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 (e.g,
<br /> MP, etc.), address and phone number. Plumber must sign application form. Fill in designer name if
<br /> applicable,
<br /> Vill Soil test information: Certified soil-tester's name, certification number. address, and phone number.
<br /> IX. County/Department Use Only;
<br /> Y. Comment area for use by county or resaor given when application is disapproved.
<br /> Complete plans and sperificatio,rs ial smaller than &1_ , '1 inches mus' oe submitted tc .lie co�rty TP
<br /> plans m,isf include the foliowing: AI plot plan, drawn to scale or w in complete dimensions i ,Lai-on o'
<br /> it,ld ng tank!sl sepflc tanks c -4h ' ,at,ent tants. b ,;�dng sewe•s, wens water ma=ns`water service
<br /> streams anr_' lakes bcxes- coir abso p .n s4sLns -ep-acemen-
<br /> °syst�!m areas. . � trP ,c,:.at: .` !�l ra ,e ,e- B c , .. !eva"o
<br /> j c rnr efe sPe(Iflcatiors fpr �,`.,r-,nc all, con LS' 1,se Y"turnP_ ale calm, 'Iff,,re,,--F fr -+ c- lo,c n�lrc
<br /> performance chi Ve }'on-.i node: anu j.. _ _...,re crags sec"on cs me _ �vste,r- ,
<br /> requ,reC by the -o ,rT, EI so' :es'v = fon
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