HomeMy WebLinkAboutReview Checklist 3- -3-� �
. TOWN OF YAR�IOUTH
SEWAGE PLAN REVIE,"W CHECKLIST
• Location: A.M. � � Lot� Zone of Contribution: In_ Out�Acreage
Commercial: Residential:�_
s��: ��f �� Gc�� ��� � -�
Village: /�!i Floor Plan: #Bedrooms: S�a iC ' �
own�: ���rN-r�li' ��n�: r cOG� ���fD�lirSrrr
Address: Phone: �-7�- 7 �-
Phone: �
Builder: Engineet: �iG! v"�(.��
Address: Phone: � - �� �j-3/�
Phone: - �j a�c � ,Qc�7 �'/�
N/A YES NO
1.R ired#of co ies received
2.Date of soiLs exam and colation test not older than 2 ears �/
3.4-5 ft of na occurrin ervious material, above wata table
4.Foundation 2 ft above hi oint of road H.P.: Fnd: Var.:
5.Water line 10 ft from s tic com one�s Var.: �/
6.Benchmark indicated and shown-NGVD if near wetlands `%
7. S ric tank minimum 10 ft from foundation, deck Vaz.: ��
8.Leachin minimum 20 ft full, 15 ft crawl, 10 ft slab Vaz.: ��
9.Leachin minimum 100 ft from wetlands Var.:
10.I,eachin minunum 150 ft from drinkin welU25 ft irri rion well Var.: �-�
11.Tauk/leachin minimum 10 ft from r line Var.: ��
12. S stem meets all other setback r uirements Vaz.: �f
13. Uses ad'ustmetrt for maximum hi oundwater Vaz.:
14. L,eachin set 4-5 ft above ad'.water or bottom of test hole Var.:
15. S stem not in to or subsoil(A,B horizons)or 5' removal
16.Pr sed contours are suitable
17. S stem meets slo e r irements-min. 1/8", Y<" eferred `/'
18. S stem meets breakout r irements PVC liner: Wall: �i
19. S ecified tee sizes are ro c,x, baffle on ouUet tee
20. Sewa e is under 10,000 d for azcel
. 21.No ba e dis osal
22. S stem ad uatel sized for its intended use
23.Minimum 6"stone or com ed below tank and dbox
• 24.Manhole covas within 6"of de, um c6amber cover to ade
25. ion on lastic chambers/leach field
26. Electrical ermit for um chamb�/S arate meter for du lexes ��
27•P system-2" line,w hole,check valve,tee in dbox, um size
28. S ric tank/ um chamber to be facto wa roofed
29.Vent rovided if leachin below 3 feet,under driveway/ arkin
30. Buo ancy calculations for tank/pum chamber
31. En ' eer to ins ect and c ' soils: wall: commercial:
32.En ' eer/Re ' tered Sanitazian and Land Surv or stam s/si ture
33.H-201oadin is sub'ect to vehicular traffic, oundwatet i-
34. Title V A lication and ermit fee,installer si ture
35.Foundation footin min. 2 feet above ad'usted ound wata for new house
36. Deed Restriction ired ma�c. #bedrooms: ma�c. flow: .�-
37.Check azea lots for oundwater/Label oundwater in Assessor's Ma
Plan reviewed by: �� ��