HomeMy WebLinkAboutApplication - 123 MARIAN DRIVE 2/23/2006 TOWN OF NORTH ANDOVER
Office of COMM IJNITY DEVELOPMENT AND SERVIC 1�S
HEALTH DEPARTMENT
400 OSGOOD STREET
NORTH ANDOVER, MASSACHLJSETTS 01845 Ssy 05
978,688.9540-.Phone
Susan Y.Sawyer,REIIS/RS 978.688.8476-.-FAX
Public Health Director E-MAIL:liciltlideptg)towiiofiiortliaiidovei-.coni
WEBSITE: http://www.townofnoi-tliandover.coni
SEPTIC PLAN SUBMITTAL FORM . ......
. .......
Date of Submission: 4,
Site Location: (A'\ L?rz- ()Vv )cir I'
P
Engineer: P1 r 7W y-I F4Ae! i )Afi IQ
New Plans? Yes $225/Plan Check# 731 (includes I"submission and one re-
review only)
Revised Plans?Yes $75/Plan Check#
Site Evaluation Forms Included? Yes No
Local Upgrade Form Included? /s/A Yes No
TelephoneFax#:-
E-mail:
Homeowner
Name: 11-J A G`1_4
OFFICE USE ONLY
When the submiss i6n is complete (including check):
Date stamp plans and letter
Complete and attach Receipt
➢ Copy File;Forward to Consultant
➢ Enter on Log Sheet !od Da abase
I
fLocailon: Owner's Name;
arcel-_
r; Add t (�°
Installer. Tel Neer(stsaL _.._gepair�_
i
Date; Z-� `� ��rC� Wetlands Ae Solt Symbol L-_Soll 1'&me_��rora. SaU Qa:; '.
Deep Observation Hole Logs
Elm-ation Depth Soil H rizoa Sall Testare Sall Color Soil Mottling 'K Gravel,Stones,etc,
MINIMUM
°1'2'2 � G,�� Lr✓
Parent I�tatetlat. '�I w rr
i �
Ikpth tonKfStsttdtr Wreerla the H �F�reeptn=ftmn!!t Face � y
rje- .
r
Pa'.rgatMetctial � � IVI✓ ° �v
Tkpth to Edlm 6tard�d=�vaterla tlta"O CL wmwt tan tk Face ESAG"1v:
Date Z' Nmolation Tests
Observation Hole R,,","E'��E,I V E 1,
Depth ofPerc
Stet Pre-soil: �r' 4.1(,")
Tlme stt]2't
Time at r ; l.�; M „r
Time at 6"
Time
Rate 11'SInl7nch I
Performed BY: f��t1u� r� Witnessed By: