Laserfiche WebLink
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-66 <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 owners 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 systemcheck 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 /> VIII. Soil test information. Certified soit tester's name.. certification number, address, and phone number. <br /> IX. County/Department Use Only, <br /> Y. Comment area for use by county o, resaor, glum when application is disapproved. <br /> �om, 'ete pians and specification- a 3nma'ie "-a^ r' '1 ncne_ r -.. submitte:i to <br /> plar- m,.st ncluj, •`.e falom rig 4 Bio' e:ar. dawn is scale or '^ t- ;;orp e u �nsio <br /> hOlc' o^ tank:'s' <:o' t, " a-ti S.. b <br /> Sbedmc an^ fYY „g,• n;! i C• . rin. h.x� cp _^�.. phn .p..,q�umo^-. <br /> 0.1 mr =la, <br /> requ t rn int i s, _ E <br /> C)n f l,y <br /> IDG Oji G' . <br />