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7-!4'/�
- TOWN OF YARMOUTH
SEWAGE PLAN REV�W CHECKLIST
' Location: A.M. Z � Lot� Zone of Contribution: In Out � Acreage
�`G i� Commercial: Residential: � �� r�
Street: � , / r-�
Village: ' � _ Floor Plan: V #Bedrooms:�s �,T""� Z'
Owner: ,����G�, .9/I 11L1 G�f`7' Insta.11er: � '
Address: Phone: �
Phane: � .-��'���.. ������ � <���
'`� S., �
Builder: Engineer:
Address: Phone: � �
Phone: f,� �C ��' � �Z ���y�
/ 1 ry
� •� �7�� ��� � � '[� � -
N/A S O
1.R uired#of co ies received ✓
2.Date of soils exam and ercolation test not older than 2 ears
3.4-5 ft of naturall occurrin ervious material,above water ta.ble
4.Foundation 2 ft above hi oint of road H.P.: Fnd: Var.:
5.Water line 10 ft from s tic com onents Var.:
6.Benchmark indicated and shown-NGVD if near wetlands �.�-�'
7. S tic ta.nk minimum 10 ft from founda.tion, deck Var.:
8.Lea.chin minimum 20 ft full, 15 ft crawl, 10 ft slab Var.: ��
9.I,eachin minimum 100 ft from wetlands Var.: .
10.Leaching minimum 150 ft from drinkin welU25 ft irri tion well Var.:
11.Tank/leaching minimum 10 ft from r line Var.:
12.S stem meets all other setback r uirements Vaz.:
13.Uses ad'ustmeYrt for maximum hi oundwater Var.: '� �/
14.Leachin set 4-5 ft above ad'.water or botto test h e Var.:
15. S stem not in to or subsoil(A,B horizon or 5'remov
16.Pro sed co�rtours are suita.ble
17. S stem meets slo e r uirements-min. 1/8", '/4" eferred �� �
18. S stem meets breakout r uirements PVC liner: Wall: �,�" '
19. S ecified tee sizes are ro , s ba.ffle on outlet tee
20. Sewa e is under 10,000 for arcel
21.No ba. e dis osal � � �
22. S stem ad uatel sized for its intended use
23.Minimum 6"s�one or com acted below tank and dbox
• 24.Manhole covers within 6"of ade, um chamber cover to grade
25.Ins ection rt on lastic chambers/leach field ✓
26.Electrical ermit for um chamber/S arate meter for du lexes ,�'
27.P system-2"line,wee hole,check valve,tee in dbox, um size �
28.S tic tank/ um chamber to be facto wat roofed
29.Vent rovided if leachin below 3 feet,under driveway/ arkin '
30.Buo anc calcula.tions for tank/ um cha.mber
31.En ' eer to ins ect and c " soils: wall: commerciaL•
32.En ' eer/Re ' ered Sanitarian and Land Surv or stam s/si ture ��
33.H-201oadin is subject to vehicular traffic, oundwater •
34.Title V A lica.tion and ermit fee,installer si ture � f
35.Foundation footin min.2 feet above ad'usted ound water for new house
36.Deed Restriction r ired max. #bedrooms: max. flow: -
37.Check area lots for oundwater/Label oundwater in Assessor's Ma
Plan reviewed by: c�o3ro3