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NON‐PLUMBING SANITARY SYSTEM APPLICATION Douglas County, Wisconsin (Pursuant to WI Admin. Code Comm 82, 83, 91 and Douglas County Sanitary Ordinance) Property Owner Information: Name: Telephone: Mailing Address: City, State, Zip: Property Description: Property Address: Tax Parcel Number: Town: Legal Description: Section / Twp / Range: YES NO Is the dwelling that is to be served by the Non‐Plumbing System connected to pressurized potable water? IMPORTANT NOTES: ‐ Structures supplied with running water must utilize a Private Onsite Wastewater Treatment System (POWTS) in compliance with Comm 81‐87 and the Douglas County POWTS Ordinance ‐ Privies are considered structures and must meet all applicable setbacks minimum for Zone District Non‐Plumbing Sanitary System Being Applied For: (indicate one system below and fill out information pertaining to that system) PRIVY (check one of the two options below): □ Earthen Pit (Requires Soil Evaluation Report completed by a Wisconsin Certified Soils Tester) □ Sealed Vault: Gallon Capacity of Vault (200 gallon minimum): gallons Manufacturer: Type of Construction: □ Prefab Concrete □ Steel □ Fiberglass □ Plastic COMPOSTING TOILET Must conform to NSF Standard 41. The disposal of any liquid from a composting toilet system shall be either to a public sanitary sewer system or a POWTS conforming to Comm 83 and Douglas County POWTS Ordinance. □ Manufacturer: Model: INCINCERATING TOILET Must conform to ANSI Z21.61 and NSF Standard 41. The disposal of any liquid from an incinerating toilet shall be either to a public sanitary sewer system or a POWTS conforming to Comm 83 and Douglas County POWTS Ordinance. □ Manufacturer: Model: Signature of Owner/Agent: Daytime Telephone: By signing this application, I give my/our permission to allow one or more inspections to be made of the site by Zoning staff, Zoning Committee Members and/or the Board of Adjustment Members and allow photographs to be taken. Date Approved: Signature: Receipt Number: Vendor Number: Permit # Date Paid: Fee Paid: Date Issued: Date: ---PAGE BREAK--- Non-Plumbing Sanitary System Application Rev. 07/2011 LOT LAYOUT DIAGRAM North South Draw and name road from which access is made to parcel. Indicate location and name of any rivers, lakes or other water bodies on property. Locate all structures (with dimensional measurements) on property. Locate any wells or existing sanitary systems. SCALE: 1 Block = feet If drawing is not to scale show all dimensions. ---PAGE BREAK--- Non-Plumbing Sanitary System Application Rev. 07/2011 Non-Plumbing Sanitary System Information (Pursuant to WI Admin.Code Comm 82, 83, 91 and Douglas County Sanitary Ordinance) Privies • The Douglas County Sanitary Ordinance and the Wisconsin Administrative Code Comm 91 regulate privies, also known as outhouses. • There are two types of privies, earthen pit privies and sealed vault privies. Earthen pit privies utilize an excavated pit at least one cubic yard in size to collect and absorb human waste. • Earthen pit privies require that a soil evaluation report be completed by a licensed soils tester to determine if the soils are adequate to treat the waste. There shall be 3 feet of suitable soils below the bottom of the pit. If the report determines that the soils are not adequate due to high ground water, bedrock or slowly permeable soils a sealed vault privy will be required. • A sealed vault privy utilizes a watertight container that has a minimum of 200-gallon capacity to collect and hold human waste. Sealed vault privies must be pumped out by a licensed septic hauler whenever the tank reaches its capacity. • The vaults may be made of plastic, concrete, steel or fiberglass. • Either type of privy is to be vented. The vent shall be at least 3 inches in diameter and terminate at least 8 inches above the roof of the privy and covered with an effective ventilating hood. • All windows, ventilators, and other openings should be screened with # 16 mesh screening to prevent the entrance of insects. • Privies are considered to be structures and therefore must meet all applicable setback requirements. Composting Toilets • Approved composting toilets must meet several standards before they may be permitted for usage in Douglas County. • They must conform to NSF Standard 41 and be listed with one of the following testing agencies; American Gas Association, Canadian Standards Association, NSF International, Underwriter’s Laboratories or Warnock Hersey. • The components for the storage or treatment of wastes shall be continuously vented. Ventilation ducts or vents shall conform to Comm 82.31 (16). • If any liquid is discharged from a composting toilet system it must be disposed to either a public sanitary system or a private onsite wastewater treatment system conforming to Comm 83. • As of February 5, 2002 there are two manufactures that we know of that have products that meet the criteria outlined above; Clivus Multrum, Inc. and Sun-Mar Corporation. • Please verify with the manufacturer that the toilet that you intent to purchase meets the above standards. Incinerating Toilets • Approved incinerating toilets must meet several standards before they may be permitted for usage in Douglas County. • They must conform to NSF Standard 41, ANSI Z21.61 and be listed with one of the following testing agencies; American Gas Association, Canadian Standards Association, NSF International, Underwriter’s Laboratories or Warnock Hersey. • If any liquid is discharged from an incinerating toilet system it must be disposed to either a public sanitary system or a private onsite wastewater treatment system conforming to Comm 83. • As of February 5, 2002 there are two manufactures that we know of that have products that meet the criteria outlined above; Clivus Multrum, Inc. and Sun-Mar Corporation. • Please verify with the manufacturer that the toilet that you intent to purchase meets the above standards. Detach: Property Owner Keeps This Page ---PAGE BREAK--- Non-Plumbing Sanitary System Application Rev. 07/2011 SANITARY SYSTEM SETBACK & REGULATIONS SUMMARY Holding Tank Requirements: - 2,000 Gallon Minimum - Within 25 feet of an all-weather service drive or road - Anchored to offset buoyant forces Sanitary System Setbacks (horizontal distance): From: To Drainfield: To Septic/Holding Tank: Building (any structure) 10 feet 5 feet Property Line 5 feet 2 feet Water Supply Well 50 feet 25 feet OHWM of Navigable Waters 50 feet 10 feet Swimming Pool 15 feet 0 feet Water Service & Private Water Main 10 feet 10 feet Privy Requirements: - Earthen pit privies require a soils test to determine soil suitability - Shall be fly-tight and vermin-proof - Windows, ventilators and other openings shall be screened with #16 mesh screen to prevent entrance of insects - Bottom of earthen pits shall be at least 3 feet above bedrock or seasonal soil saturation levels. A sealed vault privy shall conform with the requirements of Comm 84.25 relating to holding tanks and shall have a minimum storage capacity of 200 gallons. - Sealed vaults should be vented with a pipe: - at least 3 inches in diameter - which terminates at least 8 inches above the roof of the privy and - which has an effective ventilating hood on it. Privy Setbacks (horizontal distance): From: To Privy: Building (any structure) 50 feet Property Line 25 feet Ground Slope of 13% or Greater 25 feet Water Supply Well 50 feet Bottom of earthen pit must be 3 feet above seasonally saturated soil or bedrock (unless equipped with a watertight vault) 3 feet above Ordinary High Water Mark (OHWM) of lake or stream Must meet setbacks of lake / stream classification Potable Water Well Setbacks: From: To Well: Building (any projection of any building) 2 feet Drainfield 50 feet Septic / Holding Tank 25 feet Foundation / Gravity Drain 8 feet Ordinary High Water Mark (OHWM) of lake or stream 25 feet For additional well information contact: Wisconsin Department of Natural Resources Christian Martinez, Water Supply Specialist 2501 Golf Course Road, Ashland, WI 54806 [PHONE REDACTED] [EMAIL REDACTED]