HomeMy WebLinkAboutApplication - 75 WINDSOR LANE 8/23/2012 FOWN OFNORTII ANDOVER,
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APPLICATION FOR SOIL�r& S
DATE: MAP&PARCEL: (7
LOCATION OF SOIL TESTS: IA )(Vld� ' __
OWNER: Contact#:
APPLICANT:- Contact#:
ADDRESS:
14_'
ENGINEER: Contact#: AW 5�;
CERTIFIED SOIL EVALUATOR:
Intended Use of Land: Residential Subdivision ingle Family Home,) Commercial
Is This: Repair Testing:ET Undeveloped Lot Testing Upgrade for Addition:
In the Lake Cochichewick Watershed? Yes No
THE FOLLOWING MUST BE INCLUDED WITH THIS FORM
Proof of land ownership(Tax bill,or letter from owner permitting test)
8.5"x 11"Plot plan-&Location of Testing(please indicate test pit sites on the Plan),
Fee of$425.00 per lot for new construction. This covers the minimum two deep holes and
two percolation tests required for each disposal area. Fee of$360.00 per lot for repairs or upgrades.
GENERAL INFORMATION
Only Certified Soil Evaluators may perform deep hole inspections.
Only Mass. Registered Sanitarians and Professional Engineers can design septic plans.
➢ At least two deep holes and two percolation tests are required for each septic system disposal area.
Repairs require at least two deep holes and at least one percolation test,at the discretion of the BOH
representative.
Full payment will be required for all additional tests within two weeks of testing.
Within 45 days of testing,a scaled plan(no smaller than 1"-100')shall be submitted to the Board of Health
showing the location of all tests(including aborted tests).
Within 60 days of testing soil evaluation forms shall be submitted.
Please Do Not Write Below This Line
N.A. Conservation Commission Approval Date:
"'J
Signature of Conservation Agent:
Date back to Health Department: (stamp in):
K,
Grant, Michele
To: plally @millriverconsulting.com
Cc: Sawyer, Susan
Subject: FW: 75 Windsor- Soil test
Attachments: 20120824102021281.pdf
Hi Pam,
Attached please find a copy of the Soils Application for 75 Windsor Road. Please
schedule and let us know when you confirm,
Many Thanks
Michele E. Grant
Public Health Agent
Town of North Andover
1600 Osgood St I Suite 2035
North Andover, MA 01845
Phone 978.688.9540
Fax 978.688.8476
Email r nt townoffnorth ridovpr°,.rcm Web www.'"rowsiofNor,thAridover.com
-----Original Message-----
From: Rillahan, Deb
Sent: Friday, August 24, 2012 10:46 AM
To: Grant, Michele
Subject: FW:
Debra Rillahan R.N.
Public Health Nurse
Town of North Andover
1600 Osgood Street
North Andover, MA 01845
Phone 978.688.9543
Fax 978.688.8476
Email dri la,han cads cr nor t�tnandov r corn Web w w.'Towno- or~thAndover.com
-----Original Message-----
From: nor tla � w .. .... . ^�.handoe ... �1.tcwr r ccr rr � r c �
Sent: Friday, August 24, 2012 10:20 AM
To: Rillahan, Deb
Subject:
This E-mail was sent from "RNPOA428C" (Aficio MP C5000) .
Scan Date: 08.24.2012 10:20:21 (-0400)
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