HomeMy WebLinkAboutReview Checklist �z -�-��t
TOR'N OF YARMOUTH .
SEWAGE PLAN REVIEW CHECKLIST
Location: A.M. � 7� Lot�� Zone of Contribufion: In_ Out �Acreage •
Commercial: Reside�ial:�
Street: /'� �1 B2e�'/�/ : �!/�
Village: _ D��I GLf Floor Plan: I/ #Bedrooms:�_
Owner: ,��G/U/G1 `�/W/,GIv6G� � Installer: C.IrI � �(�'
Address: ' Phone: � 7 -
Phone: ,�/ ^
Builder: Engineer:
J�'uG� //� �G yf��C�/'�
Address: Phone: "�d -�73 77
Phone: ���T �,+rc�,�tccrfC'v ,
� f� � � � . ��`�B
N/A YE NO
1.R uired#of ies received
2. Date of soils exam and ercolation test not older than 2 ears ✓
3. 45 ft of natura occ�urin ervious material, above water table
4.Foundation 2 ft above hi oi�of road H.P.: Fnd: Vaz.:
5. Water lme 10 ft from s ric com onents Vaz.: � '� y " t.� , -�
6.Benchmazk indicated and shown-NGVD if near w�lands
7. S 'c tank minimum 10 ft from foundation, deck Vaz.:
8.L.eachin minimum 20 ft full, IS ft crawl, 10 ft slab Vaz.:
9.Leachm minimum 100 ft from wetlands Vaz.:
10.Leachin min;mum 150 ft from drinkin we1U25 ft irri tion well Var.:
11.Tank/leaclun minimum 10 ft from line Var.:
12. S meets all other setback uirements Vaz.:
13_Uses adjustme�for maximum lu oundwater Var.: t�
14.I,eachin se,t 45 ft above adj. water or botto test hole Vaz.:
15. System not in to or subsoil(A,B horizons) 5'remova
16. osed coMours aze suitable
17. S em meets sl e r irements-min. 1/8", '/<" erred
18. S em meets breakout r ' ements PVC liner: ';; Wall:
19. S ified tee sizes are r er, baffie on outld tee
20. Sewa e is under 10,000 d for arcel
21.No e ' osal
22. S ad uatel sized for its imended use -
23.Mmimum 6"stone or com acted below tank and dbox
24.Manhole covers within 6"of ade, ctiamber cover to ade
25. ion ort on lastic chambers/leach field
26.Electrical ermit for um chamber/S arate meter for du lexes
27. stem-2"line,we hole,check valve,tee in dbo�c, size �
28. S tic tank/ um chamber to be fact waterproofed ��
29. Vem rovided if leaclrin below 3 feet,under drivewa / arkin ,_�
30.Buoyancy calcularions for tank/ um chamber ��
31.E ' eer to ins ect and c ' soils: wall: commercia7: ��
32.Engineer/Registered Sanitarian and Land Surveyor stam s/si ture '-�
33.H-201oadin is sub'ect to vehicular traffic, undwater
34.Title V lication and ermit fee,installer si e t
35.Foundation footin min. 2 fcet above ad'usted ound watea for new house
36.Deed Restriction ired max. #bedrooms: ma�c. flow: d
37.Check azea lots for oundwater/Label oundwat�in Assessor's Ma
Plan reviewed by: `l"�(,� y�