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INSTRUCTIONS <br /> sanrtary permit Is valid k.i twc ;2) years. <br /> „r sanita y permit r -4y ',e re -e.e'' Derr- [, hF c 1,we c ewcl any new <br /> Cr iena :n NieWiscors�, .tr P (;;:: c . �i beappnu `Gfe. <br /> Al <br /> resl; ") this p,.� .n',s' ' i;,pr eve d by the peg rn;t iss:i iy auLhoniy. <br /> .1 Changes 'r cwnershir . plumber requires a Sanitanv Perr�j Tr ^ster�Renewai Form ;SBD 8399! to be <br /> scbmGted fo the county pr.cr to installation <br /> .11 ()nFit, sewage system_ rust be prope-ly m, ,Iaincd rtie sept•- 1anKil; m!s' be pumped by a licensed <br /> pumper whenever necessary, usually every 2 to 3 years- <br /> 6. If you have questions concerning your onsite sewage system, contact your !ecal code administrator or the <br /> State of Wisconsin, Safety & Buildings Division, 608-266-381.5. <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 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 B 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 /> VI!. Tank information. Fill in the capacity of every new and/o, existing tank, ''.ist 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 riot smaller than 8',6 ' 11 inches must be submitted to the county. The <br /> plans must include the following. A) plot pian. drawn to scale or with complete dimensions, location of <br /> holding tank(s), septic tank(s) or other treatment tanks; budding sewers, wells: water mamshwater service; <br /> streams and lakes; pump or siphon tanks:. distribution hoxes: 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; friction loss; pump <br /> performance curve, pump model 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) all sizing information. <br /> GROUNDWATER SURCHARGE <br /> 1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of <br /> regulated practices which can effect groundwater. <br /> The monies collected through these surcharges are used for monitoring groundwater, ground- <br /> water contamination investigations and establishment of standards. <br /> SBD-6398(R.11/88) <br />