2008/07/17 - SANITARY - SAN - Other - 13133

Home Browse Search

INFORMATION & INSTRUCTIONS FOR COMPLETING A SANITARY PERMIT APPLICATION TO THE APPLICANT: 1. This sanitary permit is valid for two (2) years, 2. Your sanitary permit may be renewed before the expiration date. and at the time of renewal any new criteria in the Wisconsin Administrative Code will be applicable, All revisions to this permit must be approved by the perm t l=sumg aulhc,ity A new permit may be needed rf there is a charge in your building plans system !c a`i, ' , e t mated wastewate- flow rem t,rr c` bec rooms, etc.). depth of system or type of system C,r.ar. ge �.: owner ;h,I> or p -i;)be- Ierluli e.s ., S _rr. - , n --ar's'e R�„eo. n `_'r G399o ! a submitted to the county p,ior to installation. Privaic se•.azgu systeriis Dr wre„e-ly to ,;s; _,nc.. u, ue pumper whener_ ^essa . every ? 'v 'V : OOEi fnniihr ",,rr�s_ .A -pp l,�rtt a,, O'necn on., or.e in #5. of '-,iwe penny' > m^ tar r e I a eaient. recon 1ec'l0r1 o: repair, �V. Type of systcrn check all appropriate boxes dependiy on system type_ Check experimental only if project is in conjunction with University of Wisconsin. V. Absorption system information. Provide all information requested in #1-6'.. VI_ Tank information Fill In the capacity of every new and/or existing tank, list the total gallons to be installed, number of tanks and manufacturer's name. Indicate prefab or site constructed and tank material. Complete for all septic, lift/siphon chamber and holding tanks for this system_ Check experimental approval only if tanks received experimental product approval from DILHR, VII. Responsibility statement Installing plumber .s to fill in namelicense number with appropriate prefix to g. MP, etc.), address and phone number. Plumber must sign, application form. Fill in designer name if applicable, VIII. Soil test information. Certified sol+, tester's name, certification numberaddress, and phone number IX. County/Department Use Only, X. Comment area for use by county or resaon given when application Is disapprovec Complete plans and specifications not smaller than -- - 11 :riches must be submitte 4 lc the fy. The plans must include the following A) plot stardraws to scale or with complete dimensions. Iccation o' holding tank(s), septic tank(s; or other treatment tanks, building sewers, wellswater mains/wate- service. streams and lakes. dosing or pumping chambers distribution boxes- soil absorption systems. replacement system areas, and the location o` the building served B) horizontal and vertical elevation reference points- C) complete specifications for pumps and controls; dose volume: elevation differencesfriction loss; pwnp performance curves pump model and pump nianufacturer; D} cross section of the soi! absorption system l` required by the county, E) soil test data on a 115 fort; - ------ .. GROUNDWATER SURCk ARGE ,;law 'c54 M, My'a:.Orb C. RJV, .-aie;