Review Checklist '
I .,
Location: AM LOT ' z Date of Subdivision Approval • 1i 2 GA
--‘ (
StreeE9_ _l i.ezilf i2t Zone of Contribution: In Out 1.--------
Village Commercial Residential 1/
'
Owner l Y1
�� "CMF(17q--
Installer YD ef: '1: E-1-EPIY111AltD. >
Builder lWit-aYk �?O1 Engineer 1 ‹A1/9E: zeNtcpmEELKi cr
N/A Yes
1. Required number of conies received. 1
2. Date of soils exam and percolation test not older than 2 years. 1
3. 4 feet of naturally occurring pervious material, above water table.I 1/
4. Foundation 2 feet above high point in fronting road. ,,/_„•
5. Water availability letter from Water Department.
6.
6. Benchmark indicated and shown.
7. Building sewer does not exit center of house. I ,�,
8. Septic tank a minimum of 10 feet from house and deck.
9. Leacrunc a minimum of 20 feet from house and 10 feet from deck.
A<
10. Leaching a minimum of 100 feet from wetlands.
11. Leacninc a minimum of 150 feet from wells.
V:
12.
12. System meets ail oilier setback requirements.
13. USGS ad'uscment used for maximum high groundwater. i
14. Learning 4 fees-above ac;usced water table or bottom of test pit.
15. System not in top cr sucsoillor 10 foot removal.
16. Proposed ccntoues'are-suitable.
17. System meets slcoe recuirements. i A,'",/
18. System meets breakout recuirement - calculations snown. l
19. Specified tee sizes are proper.
20. Sewace flow under 20,:00 cod for carcel. 7-'
21. No caroace disccsai.
22. System acecuateiv sited for its intended use.
23. Engineer to certify:
a. Clay removal.
b. 25 foot removal. //
c. Ticnt installation. Ii
d. Commercial system. !�
24. Engineer and land Sur:evcr Stamp and Signature.
25. H2O Loading • nen system is subiect to venicular traffic. I
26. Title 5 acclicat:on and fee signed by licensed installer.
27. Foundation footing 2 feet above adiusted water table. f
28. Lot subdivided prier to July 31, 1986 - Nitrate Loading. 1,>4 ''/' -
29. Subdivided prior to April 7, 1989 - Phosphorous Zone 300' 1 '
Plan reviewed by: c-1_ 1\e---
0 00 • v i,i'eS \jcv,ec� r e rAA-64"----
7/6/89 _dis
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7/6/89 -.ice
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