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TOWN OF YARMOUTH i
j SE�VAGE PLAN RE"i��'EW'CHECKLIST
Location: A.M. /z Lot �� Zone of Contribution: In Out� Acreage
: CbmmerciaL• Residential:_�y�,C� ;
Street: �� � �f �
Village: F1oor Plan: #Bedro���
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o;�vner: e Installer: ;
Address: Phone:
Fhone:'
Builder• Engineer: ���� � � �
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Address: Phone: � �"�' �
Phone: - j7/-�?%�.� �' `l� � �� �,� ,
'�vr�� ' > �1�"�'l"�
N NO �� i
1.R uired#of co ies received �
2. Date of soils exam and coiation test not older than 2 ears f
3.4-5 ft of natura occurrin ervious material,above water table ;
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4.Foundation 2 ft above hi int of road H.P.:� Fnd: Var.:
5.Water line 10 ft from s tia com onents Var.: �/ �
6.Benchmark indicated and shown-NGVD if near wetlands �f
7. S tic tank minimum 10 ft from foundation,deck Var.: 1/ �
8.Leachin minimum 20 ft full, 15 ft crawl, 10 ft slab Var.: t/ � ';
9.I:eachin minimum 100 ft from wetlands Var.: , �� i
10.I,eactun minimum 150 ft from drinkin welU25 ft irri tion well Var.: - ;
11.Tank/leachin minimum 10 ft from r line Vaz.: L/ ;
12. S stem meets all other setback r uirements Var.: �-� �
13.Uses ad'ustment for maximum hi oundwater Var.: �..�� j
14.Le�achin si.t 4-5 ft above ad'.water or bottom: s Var.: ti !
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15. S stem not in to or subsoil(A,B horizons) 5'remo C/' '
16.Pro. sed.contours are suitable �
17. S stem meets slo e r irements-min. 1/8", '/a" eferr�d �--� f
18. S stem meets breakout r irements PVC liner: Wall: �
19. S ified tee sizes are ro , as baffle an outl�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"stone or com acted below tank and dbox �/'
24.Manhole covers within 6"of ade, um chamber cover to de �/
•25.Ins ion rt on lastic chambers/leach field '
26.Electrical ermit for um chamber/S ate meter for du lexes �
27.Pum s stem-2"line,w : hole,check valve,tee in dbox, um size ;
28. S tic�znk/ um chamber to be facto wa roof� �
29.Vent rovided if leachin below 3 feet, under drivewa / arkin i
30.Buo ancy ca:lculations for tank/ um chambex �
31.E ' eer to ins ect and cert' soils: wall: commercial: �
32.En ' eer/Re ' tered Sanitarian and Land Surve or stam s/si ture ti-�
33.H-20 loa.din is subject to vehicu}ar traffic, oundwater , ,-a. i
34. Title V A lication and ermit fee,installer si ture '
35.Foundation footin min.2 feet above ad'usted ound water for new house .
36.Deed Restriction r uir� maac. #bedrooms: max. flow: d '
37.Check area lots for oundwater/Label oundwater in Assessor's Ma f
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Plan reviewed by: �o3ios