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' TOWN OF YARMOUTH
SEWAGE PLAN REV�W CHECKLIST
• Location: A.M.� Lot� Zone of Contribution: In Out� Acreage
� Commercial: Residential:�b_
st��c: 8` .� / �t� �j�_ 3 ,
Village: Ftoor Plan: V #Bedrooms: /��� � ;
Owz�er: � Installer: ���iL.
Address: Fhone: '-G� :,
Phone:
Builder: Engineer: '
Address:"; � Pl�to�e. � 'a' '"" p'�-4 ;
� Phot�e: � �� ��, �:. , � �
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N/A Y$S � . NO
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, 1.R uired#of ies received ` . .
2.Date of soils�am and` colation test not olde�than`2 ears
3_4-5 ft of'natural �ous material,aba�e Water ta.ble,
4.�oundation 2 ft abo��h� ouit of roa�i. H.P.. F�d: r r��tr .
S.�Vater line 10 ft fro�pn.s` tic com onents Var.: , ✓'�
b.Ben��tma�k.i�di�cat�d and shov�-`�C"i�D;if n�ar wet�annds
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_. . 7:;� t���ri����n�.,1��;�.;ft'9�����tios�deck ��M
, .., : _�. � �, �., ., .. .� ��
h� $, .minimim 2Q t�f�ll,;l S fk-�z�tw1, 10..ft slab ,�a�', °_�
x �x 9.-T� :�i�i�►�tn,�00��`�v���tds :Ya�>: �f �
i O::L�ching miniix�um.154 ft frs�rm c�rinkin welU25 ft m� `on w�tl Var
11.°�'a'�11�hiii �linim�rti ��y ��nm :�`. liiie ��ir: � °"� " '
12.'S tem rneets all oth�t setb�ck ` irements Var.:
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13. Uses ad'�stment for�ma�unum hi oundwater Var:: � � :
' 14.Leachin" set 4-5$above ad`:'water or bottom of test�ole Var.: '.
15.S tem not in to or subsoil(A,B horizons)or 5'removal .
16.Pro bsed comours are;suitable ; ,
.���-,17.5���stem_ineets sl e r�`��� ir�ments-,mi�.118'; '/9�''� eferr�d
� �� 18. 5��stem meets breakc�ui r irements PVC liner: �� �� W�ll. , .�
19 S ified tee sizes a�e r ,> s baffle an outlet'te�
2U: Sewa e is under 1U,000 fdr arcel
� 2I.No rba dis sal "
,< 22.'S stena ad uatel sized for its intended use
� 23.Minimum 6"stone or com ed below tank and�lbox
24.Manbiole covers.within 6"of ade, um 'chamber cov�to ade
` 25.Ins ection an lastic chambers/leach field
26.Electrical ermit for chamber/S arate meter for du lexes ,
27.Pum s stem-2"line�w , hplexcheck valve�tee in dbox,, um size
' 28:Septic tank/ um chamber to be fact wat roofed M
29.Went :ovided if leachin below 3 fe�t,under drivevva /' arkin
30.Buo anc calculations for tank/ u ' chamber �� '
3I.E . eer to ins ect and cert` soiLs: wall: commercial:
32.En ' eer/Re 'stered Sanitarian and Land Surve or s/si ature ✓
33.`H-20 loadin is sub'ect to vehicu�ar tra�c, oundwater �/"
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 uired max. #bedrooms: maar. flow: �--�
37.Check area lots for oundwater/Label oundwater in Assessor's Ma `-''�
IIII Plan reviewed by: `'�ro'
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