HomeMy WebLinkAboutSoil Testing Results - 7 OLYMPIC LANE 4/25/2014 a
TOWN OF I"401,111 ANDOVER
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1600 (04,'0 01) S°I°lill+T I"l SU I I,+a 2035
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AP"PLICA'TION FOR SOIL TESTS
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DATE: ' '�:7 MAP&PARCEL
LOCATION OF SOIL TESTS:
OWNER; t.a,,. �� � �k Contact
APPLICANT: Contact th
ADDRESS: >
ENGINEER: ,.,1y;,1, Contact
CERTIFIED SOIL EVALUATOR; 12i y a r j ��tj
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Intended Use of Land: Residential Subdivision (� mgle Fa� y H me Commercial
Is This: Repair Testing: y,f 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)
$.S"x 11"Plot plan& Location of Testing(t)lease indicate tesLp sites on the pdan)
A 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 °epairs 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 Pate. l
Signature of Conservation Agent:
Date back to Health Department: (stamp in):
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