HomeMy WebLinkAboutReview Checklist Towrt aF Ya�ou� �
�� � SEWAGE PLAN REVIEW CHECKLIST
+..ocation: A.M.__„� Lot.�j� Zone of Contribution. In_ Out� Acrcage
Gommercial: Resideirtial:�
st�c:`� 2i /� � .�_
V�llage� / Q4,K�(� Floor Plan: t/ #Bedrooms: Z-
' Owner: �/v+Y��-�P��(1/' Installer_ GC.fif�'d
Address: Phone: 7y�' �7
Phone:
; �.;Builder: Engincer:__1EL�1'I �0 4�,c�L/Lv'I
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�Address: Phone: �" � -
Phone•
N1A YES NO
1.R uired#af ies received
2. I}ate of sails eYam and ]ation test not old�than 2 rars
3.4-S ft of natural occurrin ervious material,above water table
4.Foundation 2 ft above hi int of road H.P.: Fnd: Vaz.:
S.Water 1'ute 10 ft from tic com rnnts Var.:
6. Benchmazk indicated and shown-NGVL1 if near weHands
'I. S tic tank minimum 10 ft from faundation, de�k Vaz.:
$. Ixachin minimum 24 R full, 15 ft crawl, lfl ft slab Vaz.:
9.Lzachin minimum 100 ft from wetlands Vaz.: �/
]0.Leachin minimwn ISO ft from drinkin weiU25 fi irri 'on well V .:
11.Tankfleachir� minimum 10 ft from r e line Var.:
12. S stem meeCs all other setback r uirements Var.:
13.Uses ad' ent for ma�cimum hi oiwdwater Var.: ✓
14. I,eaohin set 4-5 ft above ad'.water rn'bottom of test hale Vaz.:
I5.S stem not in or subsoil(A,B horizons)or 5'removal
16.Pr ed cantours aze suitabie
17. S stem meets sla r irements-min. 1/8", Y<" referred
1$. S stem m�ts breakout uirements PVC liner: Wall:
'19.S i#ied tee sizes are , baffle an outlet t�
,�0. Sewa e is under 10,000 for arcel
21.No ba e di osal
22. S stem ad uatel sized far its intended use
23.Min'vnurn 6"stone or com cted below tank and dbox
24.Maahole covers within 6"of e, chaml�cover to e
2S. Ins ion on lastic chambers/leach field
26.Et�trical ermit for uun chawber/S arate m�er for du lexes
27.Pu s stem-2"line,w hole,ch�k valve,t�in dbo� size
28. S tic tauk/ rrm chamber to be facto wa roofed
24.Verat rovided if l�chin below 3 feet,under drivewa 1 azkin
30. Buo ano calculations for tank! u chamber
31. ' eer to ins ect and c ' soils: wall: commerciaL•
32.En ' eerti2a ' ered Sanitarian and t,and Surv ar stam si e
33.H-241oadin is sub'ect to vehicular U�affia, oundwater
34.Title V A lication and ermit fee, installer si ature �-^�
35.Foundation footin min.2 feet abave ad'usted ound wat�f�new house
36. Ih�d Restricrion ired rna�c. #liedrooms: . flow: 'Z-
37. Check area lats for oundwaterJLabel aundwater in Assessor's Ma
Plan reviewed by: � �3