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f TOWN OF YARMOiJ`i'H
! SEWAGE PLAN REVIEW CHECKLIST
T.,ocation: A.M.� Lat��_ ZoneofContribution: In_ Oat�-�' Acreage
Commercial: Resident' 1: tn
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� Village:__ �,�{ Floor Plan: Bedraams:
I �G�L, l W Gb"� Installer: � ���dl = "�J �
Owner:
Address: Phone:
Phone:
Builder: Enginee,r:,,_�. 1'
Address: Phone:i - -?r �
Phona: � -...- �� S l+ <'L'z .
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I.R uired#of ies received
2.Data of soiis exam and lation test not older than 2 ears
3.4-S ft of natura occurrin erviaus material,above water table �-�'�
4.Foundation 2 ft above lu oint af road H.P.: Fnd: Vaz.:
S.Water line 10 ft from s tic co ments Vaz.:
b.Benchmark indicated and shown-NGVD if near wetlands v"
7.S ' tanic minimum i0 ft fram foundatio deck Var.:
8.Leachin minimum 2�ft full, 15 8 crawl, 10 ft slab Var.: �'''
9.Leaclun minin�um 100 ft frorn wetlands Vaz.: ;
S0.L�chin minimum 150 ft from cirinkin welU25 ft irri 'on weil Var.:
11.Tank/leachin miniwum 10 ft from ro line Vaz.: �:�
12.S stem meets a11 othex setback r uirements Var.:
13.Uses ad'ustment for waximum hi groundwater Vaz.:
14.Leachin set 45 ft above ad'.watar or bottam of test hole Vaz.:
I 5.S stem nat in t or subsoii(.4,B hariz+'�ns}ar 5'removal
16.Pro sed co�ours aze suikable
17. S stem mcets slo e r irements-min. 1/8", '/<" referred
t 8.S stem m�ts breakout iremems PVC lin�: Watt:
19.S ified tee sizes are ro , as baffle on outlet tee
20. Sewa e is under I QOOd far arcel '
21.No ba ' osai ;-�
22. S stem ad uatel sized for its imended use
23.Minimum 6"stone or com acted below tank and dbmc
� 24.Manhale covcss within 6"of ade, chamber cover to
25. tion ort on lastic chambers/leach field
26.Electrical ermit for chambcx/S e meker for du lexes �
27.P stem-2"line,wee hole,check valve,iee in dboa, um size ""�'
28. S tic tank/ um chamber to be facto wa raofed
29.Vent rovided if lesohin belaw 3 feet,undea drivewayt
3Q.Buoyancy calculations for tank/ um chamber '
31.Eq ' eer to ins ect and c ' soils: wall: commercial:
32.En ' eatR ' �ed Sanitarian and Land Surv or stsm si ture
33.H-201oadin is sub'ect to vehiculaz traffic, oundwatet '
34.Titie V A lication and ermit fee, installer si ture
35.Foundation foatin min.2 fed abave ad'usted ound water for new house
36. Dced Restriction uired max. #bedrooms: max.flow:
37.Check azea lots for oundwat�lLnbel wndwater in Assessor's Ma
Plan reviewed by: � ��