HomeMy WebLinkAboutSoil Testing Results - 259 GRANVILLE LANE 1/11/2008 TOWN IL O NORTH ANDOVER
Of'f'ice of COMMUNITY DEVELOPMENT AND Sf!RVICr s
HEALTH DEPARTMENT
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1600 OSGOOD STREET; BUILDING 20; SUITE 2.36 �`��?��_ •P
NORT14 -R,_%,4_ASSA :t4L"TTS 01845
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Susan Y.Sawyer,IZEKS,RS 78.688.9540-Phone
Public health Director 78.688.8476-I;AX
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TOWN OF dO(s- AP ?QV`F vw.townonorfhandover.com
HEAL 11-1€ SPAR P��lt=_NT
APPLICATION FOR�O TES`I'S...-..m.
DATE: I - I I " 0r-� / MAP&PARCEL: 10(, A l
LOCATION OF SOIL TESTS: 0 q 46 rzAN o ` ( LAje
OWNER: � \(1 !:� 17�u-7 1 -7 4-2-o
_.—_.La {�'� Contact#: ((y
APPLICANT: r Contact#: ® -7 -71
ADDRESS:
ENGINEER: 1-`Y/til,1 it•� ( Lf" ontact#: ���� �'�° °/v! 'Zd
CERTIFIED SOIL EVALUATOR:
Intended Use of Land: Residential Subdivision Single Family Home Commercial
Is T3ais: Repair Testing: Undeveloped Lot Testing: Upgrade for Addition: _
In the Lake Cochichewick Watershed? Yes No V
THE FOLLOWING MUST BE INCLUDED WITH THIS FORM
)0, Proof of land.ownership(Tax bill,or letter from owner permitting test)
➢ &.S"x II"Plot play;&Location 9L Testing,{pease indicate test pt 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 L360,00 per lot for repairsorupgrades.
GENERAL INFORMATION
➢ Only Certified Soil Evaluators may perform deep hole inspections.
➢ Only Mass.Registered Sanitarians and Professional Engineers can design septic plans.
r 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 he submitted.
Please Do Not Write Below This Line
N.A. Conservation Commission Approval Dme
Signature of Conservation Agertt: n f, ,� Po ux,}Wy w pa -{�,�i�y it)Cod;v,
Date back to Health Department-(stamp in): �1
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