HomeMy WebLinkAboutReview Checklist Location: AM /i LOT A/3 Date of Subdivision Approval_
--S.
Street
�� , 7i : Zone of Contribution: In Out
Village ( -piri. � Commercial Residential ,, - :
Owner (' kks 5��-lpA Y Installer 744
Builder Engineer peen Ip'egl54r,(AW
-X" SSS •
N/AYes No
1. Recuired number of conies received. 1 I I --
2. Date of sc:ls exam and terc:rlaticn test not older than 2 year_. I Y
2. 4 feet of naturally occur int cervicus material, above water table.' X
4. Foundation 2 feet above nigh coins in frontinc rcac. I X
5. Water availacility letter from Water Derartment. I X l
6. Benchmark indicated ant shown. I K
7. Euildinc sewer does not exit center of house. I I )(
8. Septic tank a minimum of 10 fee: from house and decn. I I X
9. Leacninc a minimum of 20 fee: from house and 10 feet from dec.`:.
xl
10. Leacninc a minimum of 1C3 fee: from wet'.ancs. I ,
11. Leacninc a minimum of 150 fee: from wells.
12. System meets ail otner setzsc recuiremenos. - I I X
l3. 11S' S ac-ust enzuses for :maximum hick crouncaater.
14. Leacninc 4 feet..accve ac-;ated w_ _ - -e,ct:n of test o: I /0
15. System not in too Cr Su:_ci 1 Jo4 10 scot remcv._. I
,. 16. P---- ccnz : re--t:facie.
17. System meets since cecu_rements. X
' I
18. System meet_ creaxcut cam••' --ement - calculations snow. i I
19. Scec:fiec tee sizes are crcoer. 1.-20. Sewace flow under 20,000 ccc for parcel.
I XI
21. No cat^ace c- -.,.ca; x I �
22. SystemVacecuately sizer for its intenced use.
2 . Enc:neer tc certify:
a. Clay removal. > •
mo
b. 25 foot removal. x
c. Ticnt installation. ›r
d. Commercial system.
>1
24. Ercinee_ and Lara Sur•;evcr Stamp and Signature. I V
25. H2O Loacina warn system :s surtecz to venicular traffic. I N,l!
26. Title : andiras:cn ant fee sinned by licensedinstaller. I
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27. Foundation fcoz:nc 2 feet above adiusted water table. I
28. Lot su divided cricr tc July 31, 1986 - Nitrate Loading. I
29. Sucaivlted cr_c: tc Aort1 7, 1°8° - Phcscnorous Zone 300' I)c
Plan reviewed by: Alget / y4o
e.7/6/89 �<` S` � � c� 6 `' �
LM:ld r-6 2 A-6,--651/4 * ti .5,10`e, �:c�� / '64XD