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TQWN OF YARMt?iITH
SEWAGE PLAN REVIEW CIiECKLIST
Location: A.M. �� Lot��� ZonaofContribution: In Out� Acreage
Commerc' • Residential:_�
' str�: 7 5u tt�r�l� ��-/
Village• �Aj�j� - - Floor Plan: #Bedrooms:
__�� Instauer: � /i,�xv�,/' f�-z'.oziv /��r�.'G7
Qwner:_�E���y
Address: Phone:
Phone:
Builder: Engineer. �GtIE'��1�/1' C.����
Address: Phone: " ��-`d' S�/6 4�j
F'hone: �..-., • . ��s,iK ' ��� C.�/��
N/A NO
l.Required#of copies received
2.Date of soiis e�caaru and colation test not older than 2 ears
3. 4-5 ft af naturall occurrin erviaas material, above water table
4.Foundation 2 ft above hi int of road H.P.: Fnd: Var.:
5.Water line IQ ft from s tic com onents Vaz.: �--�`
G. $enchmark indicated and shown-NGVD if near wetlands `"'J
7.S tic tank minimnm 10 8 from foundation, deck Vaz.:
8.I,eacbing minimum 20 ft full, 15 ft crawl, 10 ft slab Vac:
9. Leaching minimum 100 ft frorn wetlands Vaz.: --
14.Leaching minimum 150 ft from drinkin we3U25 ft irri tion weTl Var.: �--`
1 i.Tauk/leaching minimum 10 ft from pro line Vaz.:
12. S stem meats all other setback r uirements Vaz.;
13.Uses ad'ustment for maximum hi groundwater Vaz.:
14.Leachin set 4-5 ft above ad�. water or bottom of test hole Vaz.: ✓
I S.S stem not in ta or subsoii(A,B horizons}or 5' removal ✓"F
16.Pro osed contours ara suitable
17. S stem meets slo e r uiremants-min. 1/8", Yn" referred ^-�"�'
18. 3 stem meets breakout r uizements PVC: liner: Wail:
19.S ec�ed tce sizes are roper, baffle on outlet tee
20. Sewa e is under I Q000 d far arcel
. 21.No ba e dis osal
22. S stem ad uatel sized for its intended use �-�-�
23.Minimnm 6"stane ar com acted below tank and dbox
' 24.Manhole covers within 6"of ade, um chamber cover to e
2S.Inspection ort on lastic chambers/leaah field
26.file�trical ermit for um chamber/Separate meter for duplexes
27.Pump s stem-2" line,weep hol�check valve,tee in dbos, size
28. S tic tank/ um chamber to be facto wat roofed
29.Vent rovided if Iraohin below 3 feet, unQer drivewa 1 azkin
30.Buoyancy calculations for Yanklpurn chamber
31. En ' eer to ins ect and certi spiIs: wall: cornmercial:
32.En 'near/R "stered Sanitarian and Land Surveyar stampslsi ature
33. H-20 laading is sub'ect to vehicular traffic, oundwater
34.Title V A licaYion and ermit fee, installer sig��ature
35.Foundation footfn min.2 feet above ad'usted ground water for new house <'�'
36.Deed Restriction r uired maac. #bedrooms: msix. flow: d s
37.Cbeck area]ots for oundwaterlLabei oundwater in Assessor's Ma
Plan reviewed by:" �� bm3io3