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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, contactyour 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 /> 1. 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 /> VIII. 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 resaon given when application is disapproved.
<br /> Compete plans and specifications not smaile, than F`2 11 inches mus' be submitted to the count} The
<br /> plan= must include the following A; plot plandrawn to scale or with comple'P Jir)ensio r - u.at;on ci
<br /> hold!rg tank's), septc tank(s', o• ?fhetreat!-,,err tants b,ild❑g sewers ,e'I_ water ma ns-water ,e:vice
<br /> streams and lakes. dosing nr pu-9-no chambers distrlbubor boxes- so,' ansorpuon systems re, raceme^
<br /> system areas. ri ,d t1w nj, servec B hon mita a elovq*.e- -efe,e^ e ,-^,.r•S
<br /> C) % a'ete specifications f )r ow,in )5 an,:, -nntrolsdeSe V011;me PIPJ Tin^ ii'ffere^CPS fr rt-e-. 1095 �'-:ntr
<br /> perfurmance curve awn-.; mode: ani nu ".an j`arure D; cies, sec_ioi, u: the .ai at - �vster; i
<br /> requrrec' by the -oun-v. F, so `es ea:E r c '1, 'c"..
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