|
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 revisio]F 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: It 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 ##i. Complete #2 if permit is for tank replacement, reconnection or
<br /> repair;
<br /> IV. 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 /> Vlli. Soil test information. Certified soil testers namecertification number, address, and phone number
<br /> IX. County/Department Use Only,
<br /> X. Comment area for use by county or resaon giver, when application is disapproved.
<br /> Complete pians and speoiflcat;or, not smai�e, than E'-, r 11 orches must be submitted to the coun?y. The
<br /> plans mustIClude the fo'lowin,. k, plot Plan, draw- ;o scale or with .omolete dimensions locabcn U
<br /> holding tankrs). septic farnk(s o- _"hA treat—en- tan., „,„Id ng sewe _. wens wale! ns'w=_te.- ser,ice
<br /> streams and lakes. dosi c o, pvo ng boxes soi� -A”"rpt.o^ systems re,,'9CE'mP`
<br /> system areas P +1e Ic._.at e jL, d; sr• .e- S to, zo❑ta ,_ e'eva'io referer e __ _.
<br /> CI c-.e,p ete speciflcat)ors for piw n, and controls 7ese volume lar,bor c �r+er,—es trt
<br /> ee- to , n__,mr
<br /> performance .,u jt= mcde: ani o�F j ei D. cross me .oy-rc_•� ,
<br /> regcire� by ±ne odct� sc 1 -a
<br /> On AAay
<br /> result
<br />
|