DCPZP-2021-00335 - Laserfiche WebLink

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PHMDC Building Permit Review Application Page 2 n New Structure Replacement Structure (Fire,Tornado, Flood, Mobile Home Replacement, etc.): Detached Accessory Structure (Specify Garage, Pole Barn, Shed, etc.): Will there be plumbing? n Yes No Other: (*POWTS sizing is based on 2 people per bedroom using 75 gallons of water per person per day.) Plot Plan: Provide/attach a drawing of your property drawn to scale or adequately dimensioned showing lot lines, well(s), existing POWTS and POWTS replacement area (if known), all existing structure(s), proposed construction (dotted lines, or clearly labeled) and distances between above. Note: • If there are no sanitary records or soil test records on file, a verification soil test may be required prior to approval of the proposed building addition. • A POWTS found to be a cesspool or found discharging onto the ground surface or into ground water, surface water, or bedrock on the above property, will be considered a POWTS failure and the failing POWTS will be ordered corrected. Signature of owner or authorized agent is required and indicates the above information is accurate to the best of your knowledge and indicates the owner's permission is given to inspect the property for the purpose of this review. /47' Owner/Authorized Agent Date COUNTY/DEPARTMENT USE ONLY The department has reviewed the submitted plans for the proposed building addition at the location noted above. ❑ The department does not have any objections to the proposed addition. ❑ The property owner must first obtain a sanitary permit to modify/replace the existing POWTS components before proceeding with the proposed addition. ❑X The following conditions must be met resolving objection from the department: Affidavit of undersized system document must be recorded with Register of Deeds office POWTS components are sized for 3 bedroom residence and house is currently 4 bedroom. &dez/i/ON4r-**14l2 06/14/2021 Public Health Sanitarian Date Rev.4/17/19