HomeMy WebLinkAboutSoil Testing Results - 808 JOHNSON STREET 9/7/2017 TOWN d, F NCIRTH AC t3OV F.R
fJfltt e of COMMUNITY D VELOPMEN'I' SNI) ,`l"�,R VIC ES
I-II,AI34-1 DEPAI T ENT
1600 OSGOOII S'1 RE+.ET; SUI E' 2035
NORTH ANDOVER, MASS,1('I-USf:,`1'TS 01845
978.689,95410 - Phone
9711,688.8476 FAX V J
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APPLICATION FOR SOIL TESTS
DATE: a MAP&PARCEL: > 7 )
LOCA'T'ION OF SOIL TESTS:
OWNER: -Joh Y-1 Le 6 16Pt c-- Contact##: 17
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APPLICANT: / / Contact#:
ADDRESS: l54 f) a �,./ U A n'S r/1�'t
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ENGINEER: Contact#: c”
CERTIFIED SOIL EVALUATOR:. ^"t
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Intended Use of Land, Residential Subdivision Sin 1
eFamil
yHaig Commercial
Is This: Repair Testing. Undeveloped Lot Testning: Upgrade for Addition:
In the Lake Cochichewick Watershed? Yes Na
THE FOLLOWING MUST BE INCLUDED WITH THIS FORM
Y Proof of land ownership(Tax bill, or letter from owner permitting test)
Y 8.5"x 11"Plot plan &Location of Testing(please indicate test pit sites on the plan)
Fee of$585.00 per lot for new construction. This covers the minimum two deep holes and
two percolation tests required for each disposal area. Fee of4$ 40.00 per lot for repairs or upgrades.
GENERAL INFORMATION
Y Only Certified Soil Evaluators may perform deep hole inspections.
Y Only Mass. Registered Sanitarians and Professional Engineers can design septic plans.
Y At least two deep holes and two percolation tests are required for each septic system disposal area.
SRepairs require at least two deep holes and at least one percolation test,at the discretion of the BOH
representative.
Y 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).
Y Within 60 days of testing soil evaluation forms shall be submitted.
Please Do Not Write Below This Line
N.A. Conservation Commission Approval Date: ° C ��
Signature of Conservation Agent:
Date back to Health Department: (stamp in): .. c ' (` �. rV ( t bA r '.
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