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Location: AM je, LOT Date of SubdivisionApproval
Street
-- '/ fed?�G�i Zone of Contribution: In Out
Village Commercial
R-=id&itial
iJier Installer ��
• 5.6.)._ _ ..f?-,, z2„5.=,.--7 A=P•I=MEMMEIMEN•mm..........
b •
Builder
Engineer._---14=.7. 4 :_ :____ _-___.:.____
1. R�uirad number N/A Yes Nc
of c...,___ received. I
2. Dace of soil = exam and ti I
.. _ ��-.. La Cn test not older than 2 years. I
4 fee o nac____1v cc____.nc ce-viou_ material, above water t mle.l '>( 1
a- ^ • aticn 2 fart acove pica taint in fronting road. I 1
5. Water avai__cility letter from Water Decarzienc. I 1
6. Eenchmark indicated and shown.
7. Euildinc sewer does not exit center of house. I v 1
c. S_ot_c tank a mtni.^.:.:� of 10 feet from and ,• I 1
hc.....e deo... I
Leac-, ^ - 1
..c a m_n_.:a ••:t of 20 feet from house and 10 fee_ from deck. I
r
10. Leach=nc a minimum of 1C0 fee_ from w2_i 1
• � .G:1dS. � ><, I
11. Leac:;+nc a minimum of 15:, feet from wells.f mwe I �-
12. Svst_m trees ail other :et=.z `�.
c.. cersire::+.e.^.�. • I Za.
13. USCZ acus,tent used f :•maxi-. •^t i
14. LC==::lna `? - GP r for � titan Cm;'^+una•.:ater. (
fe .acc:e ac-,;_ce0 water facie or both at test o:: I ` (
15. c•� _ _.
System not Ln zoo ar euo_oil jar 10 toot removal.
16. Poor.- c .`j._w wi I
C....�_..�- a3?':'L� ^tet'. I _7C 1
17. System ,meets sicme
recut ements.
1 � 118. Svst_n neat_ emeaXcut re:harement - calc:iat_cns shown. ; I18. S^et_f:er
tee sties are • nom r
20. Seneca t'_ow under L0.000 c c for oarcei. I I
22. System acecuaca_v sizer for its Lntenced use. I 4 2
I
—22., E.^c:reer tc c .-•f .
• v:
a. Clay re.^.mova+ . I
v b. 25 foot removal.
c._i installation. I ht
d. Commercial system.
24. Er:c Knee_ ,..;
and Lan.. •evc: Stamm and Sicnature. 1
25. H2O Lcacina wren system is sun-ect to venicular
26. Ti I - traffic- 1 �-
r —.......----
27. Foundation act--~t-on -Tc "e s.c:nec by Lice.^.sed instil er 1
cation fccz_zc 2 fee: above ad,usted water table.
28. Lot su divider cr. _ - 1
�, 1986
29. Su...:jvicad or.c_ to Aer_Ju7, 1°89-Phcsmrncrous Zone�300'• I
Plan reviewed by: 4 '7t
g' -
7/6/89
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