HomeMy WebLinkAboutApplication - 445 FOREST STREET 10/3/2009 T�VVN [}FN(}RTHAH[}�VER
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APPL|CAT|ON FOR SOI L TESTS OWNER: Contact#
APPLICANT; J1
ADDRESS:
ENGINEER: &-4iAj1L1111t-'
CERTIFIED SOIL EVALUATOR: tun IAI�Lac__ C.- nsan��' j
Intended Use of Land: Residenti-A 43--F- Single Family HomeX commercial
IsThis:. Repair Testing: Ll�Undeveloped Lot Ti---::fing:_ Upgrade for Addition:
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|n the Lake CoohohewokWatershed? Yes No |
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THE FOLLOWING MUST oc INCLUDED WITH / mSrOnm !
> Proof of land ownership[7m(bill,ov letter from owner permitting test)
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Fee of8425,0Oper lot for new construction. This covers the minimum two deep holes and
two percolation tests required for each disposal area. Feeof$30l0por lot for repairs or upgrades.
GENERAL INFORMATION
> Only Certified Soil Evaluotnmmoy perform deep hole inupmctiona
;;, Only Mass. Registered Sanitarians and Professional Engineers can design septic plans.
;o- At least two deep holes and two percolation tests are required for each septic system disposal area
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Repairs require at least two deep holes and at least one peroolation test, at the discretion oftho8OH
representative.
> Full pnymentvvi|| bo required for ail additional tests within two weeks oftesting.
> N8thin45daysof testing,aecaledplan(nosmai|erthan1�100)shal| besubmi#edtntheBmrdofHealth
ehowing the|onationofaJ| tests(induding aborted tests). |
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Within 8O days of testing soil evauationfoxmeehaUbesubmitted. /
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Please Do Not Write Below This Line
N.A. Conservation Commission Ap ro ate..
Signature of Conservation Agent:
Date back to Health Department: (starTp i ' ~-kq
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