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HomeMy WebLinkAbout1437DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 34. -2 -23 BOX 13 q r 'mr I oil 16 r I� u ` I'm n + ` 1 ti'J so AL I 01437 PUTNAM COUNTY DEP41tTMENT:OF HEALTH Division of Fmtrhebmental Healtb Servloer, C uiid, N.Y 10512, j ably _ P.C.H.D. Peimk LATE OF CONSTRUCTION COhIPLIANCE -FOR SEWAGE DISPOSAL SYSTEM �� 4PIL1. . L4 (., 1/ 1 '_<./ Tam Map Bloch �=' Lot Owdee /8ppNeant'Nme sill, Formerly Subdivision Name 1 �'1r s iA�ot" M•ma� Address ?aP Subdv. Lot . � . it .% Fee Enclosed' Amount Date Permit Issued Separate Sewerage System bu0fby Address ` lam- J 1. Cabals tlnB of I (JGO Gallon Septic Tank and �� ►' h'- Water Supply: Public Supply From Addieq on J Private Supply DrWed by v Address �p t BoudmgType l�s�lo%r�l', :Lot Size- S,c 3 " Has Erosion rntitrril'Ripp.n C'nmpJat•pri? .P Number of Bedrooms - g Bar Garbage Grinder ,Beare lristalledT Odier Requirements I certify .that the systems) as listed serving .the above preimises re.,co'ns,tructed .essential,,as shorn the plans,of the completed work ( copies of which are attached), `and in accordance vith'the itandarde, rulea and r ationa, in accordance Sri the fil, lan, and the permit issued by the Putnam"County Departmennt Of Health. Date �(--lS _ ' ` CertiflW OY, P.E. O.A. A q tltl►amf I`I Li an N ti O. JF Any person occupying premium served by the above system(y she promptly take au,ch action a's may be necessary, to secure the Coneetion of any unsanitary conditions resulting from such , usme. ;Approvat,of, the Separate iawaage.syftem Shell blooms 11_11 arse: void as soon as a publ;a' sanitary saws► becomes available and the approval of the private water supply shale beoome_null rid void Whhaantea public water supply becomes available. Such approvals are subject to modification or change vvMn; in tM )utlgnNnt "ef<the ConlmifZ -'' revocation. modification or ehenge k netgsa►Y. 3/89 Date J s- Title T PCTTNAM COUVEY DEPAMICNT OF HIMU111 LUVISION GE ENS IRG`CieF&vl` L HEALTH SMVICLS IInil & Joanne Viola Owner or Purchaser of Building McGlasson Realty, Inc:. Building Constructed IDY Highview Drive Location - Street Town Of Patteram— Municigality Colonial Building Type _ -3k, 2-3 r Section Block Lot Wi nr3sor Daks SLIUlivision Name _ Lot. # 7 Subdivision Lot # GUT,T:ANTEC OF SUBSURFACE: ST�;4AGE DISPOSAL SYST04 I represent that I am wholly and completely responsible for the location, workmanship, material, construction and drainage of the sewage disposal system serving the above described property, and that it has been constructed as shown on the approved plan or approved amendment thereto; and in accordance with the standards, rules and regulations of the Putnam County Department of Health, and hereby guarantee to :die owner, his successors, heirs or assigns, to place in good operating condition any part of said system constructed by me which 'fails to c,,41 ere for a p?ri� of two-years. umiediate7.y_. following the date of approval . of the "Certificate of Construction Compliance" for the sewage disposal system, or any repairs made by me to-such system, except wtiereJ the failure to operate properly is caused by the willful or - negligent act of the occupant of the building utilizing the system. The undersigned further agrees to. accept as conclusive the determination of the Director of the Division of Environs -ental Health Services of the Putnam County Department of Health as to whether or not the failure of the stern to operate was caused by the willful or negligent act of the occupant o- lding utilizing the system. v � Dday of NOU 19 �`-� Signature Title President J� McGlasson Realty, Inc. (Owner) - Signature y► Corporation Name (if Corp.) McGlasson Realty, :Cnc. Corporation Name (if Corp.) P.O. Box 610 Carmel, N.Y _ Address 10512 P.O ,Box 610 3 Brewster Ave. Address Carmel, v.Y. 10512 rev. 9/85 mk 1 i FPM Coy WELL COMPLETION REPORT Office Use Only aJ, DEPARTMENT OF HEALTH IVV _ "Division Of Environmental Health Services L PUTNAM COUNTY DEPARTMENT OF HEALTH WELL LOCATION STREET ADDRESS AWN /VIL ! 1 Y TAXf'i10 NUMBEa: View �L14&) Oak . 7 l Q�t WELL OWNER 'a a ADDRESS: tiL1 �d P8IVATE � ❑ PUBLIC USE OF WELL 1 - primary 2 - secondary M- RESIDENTIAL O PURL SUPPLY 0 AIR /COND. /HEAL' PUMP ❑ ABANDONED ❑ BUSINESS ❑ FARM 0 TEST /OBSERVATION ❑ OTHER (specify) ❑ INDUSTRIAL ❑ INSTITUTIONAL ❑ STAND -BY ❑ MOUNT OF USE YIELD SOUGHT _ gpm. /N0. PEOPLE SERVED -6-11 EST. OF DAILY USAGE _,00 gal. REASON FOR DRILLING .. ❑REPLACE EXISTING SUPPLY []TEST /OBSERVATION ❑ADDITIONAL SUPPLY NEW SUPPLY (NEW DWELLING) ❑ DEEPEN EXISTING WEL DEPTH DATA WELL DEPTH S ft. STATIC WATER LEVEL 6 it. DATE MEASURED -� DRILLING EQUIPMENT 0 ROTARY COMPRESSED AIR PERCUSSION ❑ DUG{ 0 WELL POINT ❑ CABLE PERCUSSION ❑ OTHER (specify: WELL TYPE 0 SCREENED, ❑ OPEN END CASING OPEN HOLE IN BEDROCK O OTHER CASING DETAILS TOTAL LENGTH �_�_ fit. MATERIALS: STEEL ❑ PLASTIC ❑ OTHER I LENGTH BELOW GRADE 010 ft, JOINTS: CJ WELDED g[THREADED ❑ OTHER j DIAMETER in. SEAL: I CEMENT GROUT ❑BENTONITE ❑OTHER � WEIGHT PER FOOT II-1b./h. DRIVE SHOE Or YES ❑ NO LINER: O YES k[NO SCREEN DETAILS DIAMETER (in) SLOT SIZE LENGTH (11) DEPTH TO SCREEN (ft) DEVELOPED? FIRST _.. YES - 0 No- HOURS _..__. GRAVEL PACK O NO GRAVEL SIZE: DIAMETER OF PACK in,, TOP DEPTH ft. BOTTOM DEPTH N. WELL YIELD TEST If detailed pumping METHOD: O PUMPED tests were done is in- COMPRESSED AIR , formation attached? O BAILED O OTHER ; O YES O NO WELL LOG if more detailed formation descriptions or sieve analyses are available, please attach. DEPTH FROM SURFACE water Bear- ing Well Oia' In FORMATION DESCRIPTION coal It fL WELL DEPTH It, DURATION hr, mina DRAWOOWN It, YIELD gpm. Surface V ,Qi( 17 0 aSS 6 as_S- !� Val vo WATER O CLEAR TEMP, QUALITY O CLOUDY HARDNESS O COLORED ANALYZED? OYES ONO ANALYSIS ATTACHED? O YES O NO j STORAGE TANK: : TYPE CAPACITY GATO. - PUMP INFORMATION TYPE MAKER - MODEL CAPACITY DEPTH VOLTAGE HP WELL DRILLER NAME /3 Vt Qf ADDRESS U�c- tGiatUREE Sots iii' 6 � NUV 14 '94 10:22 FROM PAGE 02 YML ENVIRONMENTAL SERVICES 21 Kea,r- Strict Yor•�,towri He i -qrtts, N.Y. 101598 ( 914) 245-28-00 0... . p3- -7l7Va.rf.i, "...Liir4ctar LAF3. #I. 93.0098:'-R4 CLIENT #; 545 NON STAT PRfJE.. RAGE NruwJ rorr wrN ry ru rr rr r✓rrN/JMru•rr. wr rr rJ ru ru wr Mrr. -. r.•rr rr rr rr rr rw r.r r +rrrr wr rrrr M/r wr rr M/rMMrrM wr /r Mwr Mrr r +HM ►r rr lrNHnr rJ nMMMNM MwVR M.!ILA_SON BUILDERS DATE /TIME TAKEN% 11/47/94 08: PO BOX 610 DATE /TIME REG'D: 11/07/94 107. CARMEL , NY 10512 REPORT LATE: 11/09/94 PHONE4 (914)-225-7"S SAMPL I Nit - I TE : LOT # 7 W I ND$-Q`? OAK$ : H I i �HV I FW DR. F AT T E.RSON WELL PUMP COL" D 5Y'--ED MCGLASSON . NOTES,,.: M NNN NNMrr rr rn r +rr rr rrn wr rJ rr rr rr rr rJ r. r rr Nr+rr r+wl rf wr w. wwJ rrw .J w+ r.•NrJNwr wJrJ rJN NN DATE FLAG PROCEDURE RESULT SAMPLE TYPE,. PRESERVATIVES: TEMPERATURE..: COL I t~ ORM METH: N wrJNNrr rr NnJM N/r Mnrw NORMAL - RANGE 11/09/94 Me= T. COL I FORM ABSENT /100 ML ABSENT COMMENTS: LACT THESE RESULTS INDICATE THAT THE WATER a y (WAS NOT) OF A SAT I SEA4� TOO Y :.=SANITARY OVAL I TY ACC:ORD I THE NEW YORK: STATE AND EPA FECERAL DRINKING WATER STANDARDS, FOR THE PARAMETERS. TE•StED a AT THE TIME OF COLLECTION. SUBMITTED ---- _— Al b4 tr H. Padovani. r M. T/ (ASCP) 1)ir•,actor• POTASL NONE < 4G MF rrM MrlNMrr FLAP# 1052; I �ti Typal / (s/G�w 1 i rv� (,ot Ans -3s 7�- F® See!!M 0� Depth Vabl J Numbels sff Btlii� 3 Deets Plow G P D Ct2 Q 6 PC® NoNO"m la Re4dred When FM Y completed Sepen" Sawanes Sysim b ee it er1000 GM= SsPW Teak n$44S 71 'z U be eaunkeeged by / r� �ddreu Water SNP*. .. Pine SW* Fir• �°- Addtees on l/ Mreb Supply DdWd by ! f3 ® Addmw Other Dagestiera�b 1 represent that 1 am wholly'and completely responsible for the design and location of the proposed system(s); t) that the separate sew - di sal stem above described will be constructed as shown on the approved amendment there to and in accordance with the standards. rules a ►gu tons o nam County Wpartment of "Uh. and that on eompletion.thireof a "Certificate of Construction ComplianeN' satisfactory to the Commissioner of Health will be submitted to the Departmpid. and a written guarantee will. W furnisti" the owner. his successors, halts or assigns by the buildar.'that said builder will plate in good operating condition !any part of Yid sewagh disposal. system during the par 104 of two (2) yaws Immediately following the date of the Im- once of the approval of the Certificate of Construction Compliance of thq orpinat system or any repairs ther ; 2) that the drilled well deco above well be located as shown on the approved plan and that aid well will be ihsb in accordance with, the standar rule • redu a�T oi= nTof . the Putnam County Department of Health. 1 Dab $ - — P.E. _- Addra "y� d� — license No APPROVED FOR CONSTRUCTION: This approval expires two Yeah from the ,data I" unless construction o ter - building ,has been undertaken and is revocabM for cause or may be amended or modified when considered necessary by the Commissioner of Health. Any change or alterat of construction Meuirea a Permit., Approved,for disposal of domestic sanitary sewage. ! private water supply only. LO/88 Ic DEPARTMENT OF HEALTH Division of Environmental Health Services 4 Geneva Road, Brewster, New.York 10509 (914) 278 -6130 APPLICATION TO CONSTRUCT-' A 'WATER WELL - PC_Hn PERMIT !k/ ✓���� WELL LOCATION WELL OWNER Strut Address To illage City Tax Grid Number J� Cdr s Ve- VL �Ig_o a -3-4, —�- - -�--�- q Address OPr vate Name Mailing D Public SE OF WELL �- primary 2- secondary O RESIDENTIAL O BUSINESS O INDUSTRIAL ❑ PUBLIC SUPPLY O AIR /COND /HEAT PUMP O FARM O TEST /OBSERVATION U INSTITUTIONAL O STAND -BY O ABANDONED O OTHER (specify O AMOUNT OF USE YIELD SOUGHT gpm /# PEOPLE SERVED /EST. OF DAILY USAGE 4,0C)_ga1 O REPLACE EXISTING SUPPLY O TEST /OBSERVATION Q ADDITIONAL SUPPLY NEW SUPPLY (NEW DWELLING) ® DEEPEN EXISTING WELL REASON FOR DRILLING DETAILED REASON FOR DRILLING WELL TYPE DRILLED DRIVEN ODUG C3 GRAVEL OOTHER I IS WELL SITE SUBJECT TO FLOODING? YES NO IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: i'v Lot No. 'Z WATER WELL CONTRACTOR: Name Address: IS PUBLIC WATER SUPPLY LVAILABLE TO SITE: YES NO NAME OF PUBLIC WATER SUPPLY: A_J ! - �JIST:+�jCE- T -0 vgrJvFRTV . FRr)M_- NEAREST WATER. MAIN LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED %0N SEPARATE SHEET (date) ( gnature) TOWN /VIL /CITY PERMIT TO CONSTRUCT A WATER WELL This permit to construct one water well as set forth above is granted under the provisions of Subpart 5 -2 of Part of the New York State Sanitary Code, and provided that within thirty (30) days of the completion of water well construction, the applicant shall: 1. Pump the well until the water is clear. 2. Disinfect the well in accordance with the requirements of the Putnam County Health Department attached to this permit. 3. Submit a Well Completion Report on a form provided by the Putnam County Health Department. During all well drilling operations, the applicant shall take appropriate action to assure that any and all water or waste products from such well drilling operations be contained on this property and in such a manner as not to degrade or otherwi to rface or groundwater. Date of Issue: 19 Date of Expiration 190 Permit Issuing Official Permit is Non - Transferrable White copy: HD File Pink copy: Owner 3/89 Yellow copy: Bldg. Insp. Orange copy: Well Driller T -1 F0 LL - n ! 1 � KITCHEN f BED RM D G QO 1: �. I I �� I I N a 1 O II p o BATH _ I r T O J 9 O; IS - - - !t -- 1 �I 6c. -c�«• c Q rl I 1— -r IPA `5'0" 1 '4-4:j I =e 11 z' 111 z'•o : ±1 •' i I I I NEW TOR[ STATE OMS1O7 OF NOUVWC • L 5TA14P OF APPROVAL FOR AyyN�OD'_L OR COMPONE14T crama?rpr�7PP0Yal00. PC���1 1 I - Otl[ Cf t�T6Ytl 00361 NOV 12 Isar L .- C7: rc£TwS A0'"CUL Swt[[ R71 AsIKY[ UE wAwOfAC• fMOM 0[SP:a:1yl:rtr fOA VEVIAltX1 fPZJ 7 AF- �'1'�• C L. Cc:e[rf5 t-3 WZS IMS A►PPCYI.I A!l6 Y[ wtw P[S00ASan nY fCt CAAOAS OR is • Oe4SCAS. O:r+ P ^ W.0 A CE&Ua f Lx �za• t/• {L {001 I Be )PU7CN,P�IMC COiJNT'X" ]�EP.P,.RTMENT <D )F IIEAX- Ar3cli - - APK71—CAT ON FOR `.'ARP.'Z'V L 101F. LA?I-5• -FOR -A WASTEWATER- ..QLSPOSAI: SYST H.- 1. Name and Address of Applicant: ./�l� F S- 2. Name of Project: /wC( ore S� 3.._•_Locatiog7 Y /C:. a 'may 4. Project Engineer: GL� �� �� �% r 5. Address: �1,,���zY�l e- ,�el.�, , Y License Number: f Phone:- �— /_(�� 6. Type _of Pro.iect: L Private /Reside.ntial Food.Service - ....Commercial Apartments Institutional Mobile Home Park Office Building Realty Subdivision Other (specify) 7. Is this project subject'to State Environmental-Quality Review - (SEQR)? Type Status (Check One) Type I... Exempt Type II. Unl fisted, /,,I- 8. 'Is a Draft Environmental Impact Statement (DEIS) required? 9. =Has DEIS been completed and found acceptable by Lead Agency? .. .......... 10. Name of Lead Agency 11. Is thi- s-project in- an area under the contr- o-l- -of -local planning,-- z- on- i -n.g, or other officials, ordinances? . . 12. If so, have plans been.submitted to such: author .s ties? ..................... _ 13. Has preliminar y a/ pproval been granted by such authorities? /li/. Date Granted: 14. Type of Sewage Disposal. System Discharge...... Surface Water lzGround Waters 15. If surface water discharge, what is the stream class designation ?........ :6. Waters index number (surface) ........... ............................... 4101 i7. Is project located near a public water supply system? .................. /� d S. If yes, name of water supply /U//+ Distance to water supply r :9. Is project site near a public sewage collection or disposal system ?..... o. Name of sewage system 1�� -- Distance to sewage system ...,UA• :1. Date observed: 23. Name of Health Inspector: /fir Ltl l� �g c x 4'. Project design flow (gallons per day) ..................................... L_e G - ♦ r• • 2. 25. Is State Pollutant Discharge Elimination System (SPDES) Permit required ?. o 26. Has SPDES Applicatioi been submitted to local DEC Office? ...........�.... 27• Is any portion of this project located within a designated Town or. State Uff wetland? .................................. ............................... � 28. Wetland ID Humber,.. .............................. --�_ 29. -Is Wetland Permit• required? .............. ............................... d Has application been made to Town or Local DEC Office? J" 30. Does project require a DEC Stream Disturbance Permit? ................... U 31. Is or was project site used for agricultural activity involving application of pesticide$ to orchards or other crops, solid or hazardous waste disposal; landfilling,•sludge application or industrial activity? ........ YES 'or NO ✓� 32. Is project located-within 1;000- feet of existence of abandoned. 1andf111 hazardous waste site, salt stockpile, landfill, sludge d'isposal site or any other potential known-source of contamination? ..............YES or NO DESCRIBE: 33. Is th &re a local master plan or file with the Town or Village? 34. Are community water, sewer facilities planned to be developed within 15 years ? - '41d 35. Are any sewage di-spcsal areas in excess. of 15ro slope? ...:.. 36. Tax Map ID dumber ......................................... ..�y 37. Approved Plans are'to''be: returned to: ................ • Applicant Engineer If the application is signed by a person other than the applicant shown in Item.1, the. application must be•acccmpanied by -a Letter of Authorization: Failure to comply with this provision may be grounds for the rejection of any submission. I hereby affirm, under penalty of perjury;- that information provided on this form is true to the best of my know7edge and be l ief. Fa 7se statements made herein are punishaLp7e as a Class A Hisder„eanor pursuant to Section 210.45 of the Penal Law. SIGNATURES & OFFICIAL TITLES: 'AILING ADDRESS: • /• •• DI• • '�� la • • N Y• Y • • a �• • la Y •ly AM, �• Ma. Owner . % +.1,� I�L G` Address -O d l/ l Ly 6 +� P h' `y h � / li h 1 G •r� ( � Lz&I') Located at (Street) . /,,, ✓ �- Sec. Block . ;; Lot ?� (indicate nearest cross streetY ,( Watershed . MLII11Clpallty �4- �•m-; Oh - . SOIL pa- CM =C7N-•TEST DATA RDQt= TO BE . SUPMI= WITH APPLICATIONS Date of Pre- Soaking -7 / `t Date of Percolation Test h� � 'HOLE P Namm CROCK TRIE PERCOLATION FF2COLATI(XZ Run Elapse Depth to Water,]Frcm. Water Level No. Timr Ground Surface In inches Soil Rate,.• Start Stop. Min: Start Stop Drop In Min/I.n Drop Inches Inches Inches ' 1 11; �t5 Gl '3"9 1 �• 4,7 2 a-% 3 S A ... -... _ _1 _.. i • 5- /1 2 17-; or 12- 2-0 I r 2 3 1 L' 2-I 12,' 3 q i. 1 -- 3 4 5 NC7I�5: 1. Tests to be repeated at same depth Until approximately equal. Soil rates.. are obtained at each percolation test hole. All data to* be submitthd for review. 2. ; , Depth reasurements...to, be made fray top of hole. TEST FIT DATA REQUIRED TO BE SUBMITTED WITS -APPLICATION LESCRIpTION OF SOILS ENCDUNTE2ED IN TEST HOLES DEPTH HOLE NO.,, HOLE NO. .��- HOLE NO. G. L. 1' 2' S e9—hF. 3' 4+ - 5' G+ 7' 1 91 .10' 11' 7-0 75s31 L- .,5'61+D u! Pock 12': 13' 14' INDICATE LEVEL AT MIC H GROUNDWATER. IS ENCOUNTERED INDICATE LEVEL TO. MICH 4ATER LEVEL RISES AF'T'ER BEING ENOOUNTTE RED A) .DEEP HOLE OBSERVATIONS MADEiBY: A, , DATE: % G Y DESIGN Soil Rate Used - Min/1" Drop: S.D. Usable Area Provided No. of Bedroans 3 Septic Tank Capacity i 0'6 gals. Type Absorption Area Provided By 3 0 G L.F. x 24" width trench Other Nam. Signature Address Y . "� " "rdo� C_.J "N��.�:,�_, -�� SEAL AL THIS SPACE FOR USE :3Y EEALTH DEP,AFtMENi ONLY: ass' Soil Rate Approved . sgoft ✓ gat Checked by Date 12': 13' 14' INDICATE LEVEL AT MIC H GROUNDWATER. IS ENCOUNTERED INDICATE LEVEL TO. MICH 4ATER LEVEL RISES AF'T'ER BEING ENOOUNTTE RED A) .DEEP HOLE OBSERVATIONS MADEiBY: A, , DATE: % G Y DESIGN Soil Rate Used - Min/1" Drop: S.D. Usable Area Provided No. of Bedroans 3 Septic Tank Capacity i 0'6 gals. Type Absorption Area Provided By 3 0 G L.F. x 24" width trench Other Nam. Signature Address Y . "� " "rdo� C_.J "N��.�:,�_, -�� SEAL AL THIS SPACE FOR USE :3Y EEALTH DEP,AFtMENi ONLY: ass' Soil Rate Approved . sgoft ✓ gat Checked by Date a.. ...: K._ .._ P.tiT :1hNI' DIVISION OF ENVIRONMENTAL HEALTH SERVICES Date Re: Property of Locatedat ()rl�e -- (T)� UJ- vrtG'� Section 2 ±, Block Subdivision of S `Ci 1 y -to -� t Lot 3 Subdv. Lot # % Filed Map # Date Gentlemen: j This letter is to authorize �V" cr a duly licensed professional engineer y or registered architect (Indicate) to apply for a Construction Permit for a separate sewage system, to serve the above noted property in accordance with the standards, rules or regulations as promulagated by the Commissioner of the Putnam County Depar_tinerit: of Uealtli:,,:_arid�to__s gn . all_,necessary.: papera._ on-my behalf ^in connection with this matter and to supervise the construction of said system or systems in conformity with the provisions of Article 145 or 147, Education Law, the Public Health Law, and the Putnam County Sani- tary Code. _ OF E Counter ne` q s�o o.55124 P.E. , R.A,,, ,A _ V Very truly yours, Signed Owner of Property 2-a Address Address Tow R Telephone Telephone LAURENT ENGINEERING -3CCiATES P. MILLBROOKE OFFICE CENTRE Route 22 8 Milltown Road Brewster, New York 10509 RANDOLPH W. LAURENT, P.E. (914)278-6108 - (FA)n 278-2658 HARRY W. NICHOLS JR., P.E. CONSULTING SITE ENGINEERS August 10, 1994 Putnam County Department of Health 4 Geneva Road Brewster, NY 10509 ATT: Mr. William Hedges RE: Proposed SSDS Highview Drive Patterson, N.Y. Dear Bill: Enclosed are -the following: 1. Four (4) ;prints of Drawing SS -1 "Proposed SSDS", dated 8 -8 -94. 2. "Application For Approval of Plans For a Wastewater Disposal System ". 3. "Construction Permit for Sewage Disposal System ", dated 8- 10 -94. 4. "Application to Construct a Water Well ".,. dated ... 8- l0- 94._. - 5. "Design Data Sheet ". 6. "Letter of Authorization ", dated 8- 10 -94. 7. Two (2) copies of Residence Floor Plans, for "Bedroom Count Only ". 8. Check in the amount of $300.00, review fee. Please review the enclosures and issue the construction permit at your earliest convenience. Very truly yours, LAURENT ENGINEERING ASSOCIATES, P.C. Harry W. N'Q ols, Jr., P.E. HWN:bd `J 94065 cc: Mr. E. Viola w /enc. Ms. D. McGlasson APPENDIX 3 pU,TN, A-M COUNTY DEPARTMENT OF HEALTH - DMSION OF ENVIRONMENTAL INDIVIDUAL WATER SUPPLY & SUBSURFACE SEWAGE DISPOSAL REYIE�C_SHEET for- CO�STRUC'TION PE R�f IT [ANNE OF OW -NER �! _�% STREET LO DATE � TAX SLAP T Y t p !� L PER`ffI';� PWS LETTER ' AL- IHORIZAT 0 GN DATA SHEET(DDS) Lf C LE LOG r. I NT PERC RESULTS (3) R 'OLL DEPTH Ti C RATE RESOLUTION 71, -S Tlr-_RE E SETS 1 WOUSE PL -_ S -TWO SETS ! VARIAN -REQUEST NERAL G �GALSLDDIVTSION �� v SLBDIV c- .N P L C: rC D FILL REAL mSTA \PIPES 'CLRTAP DRAIN REQVTRED E.X- APPRC %'AL SSDS ADJ. LOTS _! S�- ETI_kx D JO N /DEC PERMIT R & D) LYDATA ON DDS PLANS & PERMIT SAME PRE- 1969 -NEIGHBOR NOTIFIFICATION LETTER BLZBA F'iOCD ELEVATION ,SEWAGE SYSTEM PLAN - (NORTH ARROW) SDS HYDRAULIC PROFILE m GRAVITY FLOW D/ J BOX © TRENCH/GALLEY M P- PIT DETAILS SEPTIC TANK - SIZE, DETAIL WELL DETAIL, SERVICE LINE IF OVER CONSTRUCTION NOTES (GRINDER RATE) SIGN DATA: PERC AND DEEP RESULTS VO -FOOT CONTOURS EXISTING & PROPOSED RIV'EW:AY & SLOPES CUT FOOT - 'C,GUTTER/CURTAIN DRAINS )MMENTS: HEALTH SERVICES SYSTEMS [HOUSE CHARGE (OKC & DEEP HOLES LOCATED RESENTATIVE OF PRLViARY ACID EXPA'VSION . AREA; SHOWN; GRAVITY FLOW, SUFF.SIZE UMPED PIT & D BOX SHOWN DETAILED SE - NO.OF BEDROOMS LLS & SSDS'S tiV/IN�I 200 FT. CF PROPOSED SYSTE_ PERTY METES & BOU`-DS SE SETBACK NECESSARY (TIGHT LOT) SEWER - 1 /4 "/FI. 10; TYTE PIPE BENDS; BENDS =5 W /CI:.ANOU -T CLAYBAKF,Ltk 10 FT HORIZON SPE 0 FILL TRENCH �- LF TRENCH PROVIDED SLOPE 3:1 TC GRAD ;SONS T MAY PARALLEL TO CONTOURS h°'o EXFAIySION PROVIDED — — 10' TO P.L., DRIVEWAY, LARGE TREES, TOP OF FILL . 20' TO FOUNDATION WALLS m 00 TO WELL, 200' IN D.L.O.D., 150' PITS CCl 100 TO STREAM WATERCOURSE LAKE (NC.EXP.A:N) CD 0' TO CATCH BASIN, 35' STORMDRAIN, PIPED RATER m 0' TO WATER LINE (PITS -20') �J 0' NTEM TTTENI DRAINAGE COURSE LZ7 00 FT. RESERVOIR, ETC m 150 FT. GALLEY SYSTE`iS SEPTIC TANKS m 1 'FROM FOUNDATION; 50' TO «-ELL NULLS m 15' NN- LL TO P.L. now MMWMM-� 9sj,9� lei Ir o- /y , �y 3P- P �l ,a FIA1,11-4 EX /ST. WELL B r331�1�"?OOH D E n � Yv v 1 I SEPT CATANK ' � L= 225.00' r'" o, o� V 4? 'ul � } 9 , 7_I t' i I TAX MAf Putnam i ivieion of ?plicable F utnam Count K� DPO-JECT .45 - 84//Z r DIMENSION CHAR TtlINAr) N? A 8 40.5, 41. 0' 3 28.5'� 30.01 4 23.5' 25.01 5 58,0' 84.5' 6 -360, 61.5' 7 41. 0' 68.5, 8 73.0 50.5, 71.5' 475' /0 A, B, Sr 370' 0' ---f V O O