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HomeMy WebLinkAboutSoil Testing Results - 114 REA STREET 4/11/2006 uwr our<.uvo VV.11 �f OJGl O1 JD IVC tlVUll`IttK1fVU I-'AUL 02/U3 TOWN OF NOPTH A DOVE,R y4®sTka Office of COMMUNITY DEVELOPMENT AND SERVICES �.'�:'. •�'`°`°� HEALTH DEPARTMENT a 400 OSGOOD STREET NORTH ANDOVER,MASSACHUSETTS 01845 cncFwgt•�' 'Susan X.Sawyer,ItUHS,RS 978.688.9540—Phone Public Health Director 978.688.8476--FAX ealthJWMAwno Qtthandovcr www,tOvmofnorthandover.com APPLICATION FOR SOIL,'BESTS PATE: I- _ MAP&PA:RCEL: LOCATION OF SOIL TESTS: OWN EP_ Contact#: 5u 4 APPLICANT:_ Contact a. ADDRESS:--114- LNGINEER: o,. v Contact Cl'sRTIF111®SOIL EVALUATOR - �•7 Intended Use of Land: Residential Subdivision Single Family H Commercial s his: Repair Testing: Vz Undeveloped i ot'T"tiRg:_ _ Upgrade or Addition: In the Lako'Cochichewick Watershed? Yes No THE FOLIAWING MUST RE INCLUDPD Wim Tins FoRR A Proof of land ownership(Tax bill,or letter from owner permitting test) D 8.5"x.I t"Plot nlan A Juecadon o es_ (nlemse i dscate test din cftcc on tlrc nl�n) D Fee of 5425.00 per lot for�construction. This covers the minimum two deep holes and two percolation tests required for each disposal area„ FCC of"00-M per lot fore airs or u - des. GENERAL INFORMATION D Only Certified Soil Evaluators may perform deep hole inspections: Only Mass.Registered Sanitariam and Professional Engineers eats design septic plans• A At least two deep hol©s and two percolation tests are required for eaeh'septic system disposal area. D Repairs require at least two deep holes and at least one percolation test,at the discretion of tine Bo H representative. > Full payment will be requited for all additional tests within two weeks of testing. D Within 45 days of testing,a scaled plan(no smaller than),"-100')shall be submitted to the Board of Ilealth Showing the location of all tests(including aborted tests); 0- Within 60 days of testing soil evaluation forms shall be submitted. Please Do Not Write Below This Line N.4 Conservation Commission el D Signature of Conservation Agenet. Date back to Health Department:(stamp in): fs 1(rW �I�l�wt'��t - PV a557--OCIOT�M ak os ufrb D i f 1111;7 PeA