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HomeMy WebLinkAbout2308DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 41.10 -2 -14 BOX 20 - `,- Ir .- . IL rP ., ir 02308 1 Al DEPARTMENT OF HEALTH Division of Environmental Health Services 4 Geneva Road Brewster, New York 10509 Tel. (914) 278-6130 Fax (914) 278-7921 BRUCE R. FOLEY_ "Pub -lit ` Health "Director PROPOSED ADDITION APPLICATION (RESIDENTIAL ONLY) pofnavn STREET,' J-Z ,kake Eh oke- kd• TOWN TX MAP # NAME PHONE X96- 7A GC PCHD #� MAILING ADDRESS P t) - l-o X e; 9'0 LTWC e ks or) VA Necf _ A/4 16--3-3-,5-- a &'7 o DESCRIPTION OF ADDITION enclose poyeh t- h V ,' - e yctid h OP . r3�ooynS NUMBER OF EXISTING BEDROOMS PROPOSED # OF BEDROOMS �. (FROM CERT. OF OCCUPANCY OR CERTIFICATION FROM BUILDING INSPECTOR) *Any addition which is considered a bedroom requires formal approval of plans (Construction Permit) prepared by a Professional Engineer or Registered Architect in accordance with applicable sections of the Putnam County Sanitary Code. Please submit this form and the following to Putnam County Health Dept., 4 Geneva Rd., Brewster, NY 10509, Phone 278 -6130. 1. Certified check or money order for $100.00 2. Sketches of existing floor plan (drawn to scale, all living area including basement) . * Non - professional sketches are acceptable 3. Two sets of proposed floor plan (drawn to scale, with name, street, and tax map #) * Non - professional sketches are acceptable 4. Copy of survey showing well and septic location, to the best of your knowledge. Include date of installation if known. Label all wells and - septic systems within 200 feet of the property line. Contact this office with any questions. 5. Copy of Cert. of Occupancy from Town or Certification from Building Dept. with legal bedroom count of dwelling. OFFICE USE Comments Feb 98 . .r BRUCE R. FOLEY 'Public Health' bisector !�I LORETTA MOLINARI R.N., M.S.N. Associate Public Health Director Director of Patient Services DEPARTMENT OF HEALTH 1 Geneva Road Brewster, New York- Environmental Health (914) 278 - 6130 Fax (914) 279-7921 Nursing Services (914) 278 - 6558 Fax (914) 278 - 6085 Early Intervention (914) 278 - 6014 Fax (914) 278 - 6648 WIC (914) 278 - 6678 Fax (914) 278 - 6085 January 12, 1999 Ivan Phillips P.O. Box 670 Jefferson Valley NY 10535 -0670 Re: Addition - Phillips, 552 Lake Shore Road Increase in Number of Bedrooms (T) Putnam Valley, TM# 41.10 -2 -14 Dear Mr. Philips: I have received and reviewed the plans for the proposed addition to the above- mentioned residence. The proposal-for the addition has been approved as per plans bearing the latest revision date of January 11, 9999 and this Department's approval stamp. Based on the information submitted, the above - mentioned addition is approved with the following conditions: 1. The total number of bedrooms must remain at two without prior approval by this Department. 2. The area of the existing sewage disposal system, and its expansion area, must be maintained. 3. All plumbing fixtures must be updated with water saving devices, i.e., new low flush toilets, restructures for shower heads and faucets, etc. Any other permits or variances required are the responsibility of the applicant and the jurisdiction of the Town of Putnam Valley. If you have any questions, please contact me at your convenience. Very truly yours WH:tn William Hedges cc: BI (T) Senior Public Health Sanitarian PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES INITIAL 'INDIVIDUAL ADDITION / REPAIR FORM SECTION A. GENERAL INFORMATION Name of Project �s2 L� ��`5l`�''`D(T)(� /' TMg Year of Construction Size of Parcel SECTION B. TOPOGRAPHY (Please check all appropriate boxes) f. 1. millyMolling ateep,slope Mentle slope Mat Modies of water 2. ❑Evidence of wetlands ❑D A. Clow areas subject to flooding LyR k t I ag e rtc es oc ou crops YES NO 3. Property Y lines evident? ❑ ,. 4. Water . u .....s.... � _._.. 'r .-parcel? ^ U ❑ Water courses exist on, o adjacent to p exis in ❑ 5. Existing individual wells within 200ft of th e t g SSTS? SECTION C.. EXISTING SUBSURFACE SEWAGE TREATMENT SYSTEM (SSTS) 1. Physical character of existing SSTS area. A. r Level Gentle slope r1teep slope B. OWell drained Moderately well drained OSome what poorly drained OPoorly drained C. Area available for SSTS. (Primary &:Reserve) , CIE x1tremely limited Clomewhat limited OAdequate ft x ft 2= r ' 9 f D. INSPECTION Date / L Inspector ONo'evidenceoffa . Bure U Evidence of failure . LJEvidence of seasonal failure ------- - - - - -- -------------------- -- - - - --' (Indicate North) ' �- HOUSE / --- - - = - -- --� - -- (1) Indicate location of SSTS A. Size and type of septic tank gallons Metal OConcrete MPlastic B. Type of absorption area 1. Fields ft. - 2. Pits 3. Gallies $. (2) Indicate- setbacks. front street, backyard, and side-yard dimensions (3) Show location of well (4) Show location of driveway (5) Note physical features (steep slopes, rock outcrops, streams /wetlands) SECTION E. EXISTING WATER SUPPLY DPWS ® well Individual well Mrilled Mug Casing above ground COMMENTS : ��,� 0 ,5✓ I%.,. AlUVILT ENGINEERING CO. t t ��� i , • p � ,il Auto INS '.1t 4 1 1 0 all an ONE 0 0 u in ON mollms =a MOONS mono a No MEMO WE a oil �■ii� �iii�� M�n�i�ii : iii i �eEs � � ' � ,ii �C "C� "C ,iiii no I MEN -18 00 m ME ME EDQF Or m: No9.:I. - a 33 F •M --.. �.,,. Q (Slip 8 5 2 -,Q� F w1A 12Q, 026 E p / cam. E�tr.�1 GPs _ws p�..•�°jam }''/ . � i.QVi ^.!� -r�. .'" /' � , . FLTST0W STONE MAS. 110 _- (TYPICAL] .. . f G.J i LOS - ARE4 -. 1� L6 OR 0.364 46RE'S O N/f Rt .� SAW: : MA.S _... •+%•,.;cit- ':a:...- :- ,. .. Fd.i. h:1:.� t•._ .If)ON PIN 4KEfYAWCA FDUwD -, WALK ' 0: ! NOR7H `IRON'PIPE / h'ALL h0� :.FOUND (ECK ROLr 0--4 .,NOR TH �--- -i ' \ C rAJACY AN.. ., _ _ . _..;`-. \. _ .- ..._ .. _ _ I +iii �'T CD .•�. . ' _ aseQ „r�►� AG. 5:52. Vol BANTER OP' RETAONING ._ 1.93' _. ` Q r - MALL F S¢.p L i • �. ! . MaSnvyr Taltil lei �1 .. WALL IRON R00 FOUND - �1X+E Lip MAC. T CORNEA. MALL tav'Z J�aRiCI�Y; 02' AWTH 507 *48'10'E 90.00 ' EDGE OC MAC XIAES J2' I1MtH ROA.D i Du 00coe L eve k 10 Sl- rviY MENT OF HEALTH HOUSE PL N!S APPROVED FOR BEDRoort.4 COUNT ONLY, Laic -e $�tar� K�' Z C'811 1F ,� C) _ Z - / Signature & Twe i..... .. r 3.ori ti 4'� /i - R.O. __ _ _ R.O. � Ra• �I. S © S 0 FI � I r. 1i�ik j ij r j wil <o . POOc k �c� r I �• • i wu�{u�; r, ,-- IZ° x lz: MfX ICN�J m ;u �1 :, hh PUTNAM COUNW DEPARTMENT ZF44F -J L . L (I PS HOUSE PLANS APPROVED VOR BEDROOM Goulvff COUP F1L C. Ali L//. /0 & yak Date _.: ve %l CA l.Jt���i -y S�ngte Cv� Room G'dvage thienneq �-0 8ase✓nanY A wp �sely R° lck) _ ieo r 'o 0 301 PUTiNAM COUNT Y DEPARTMENT OF HEALTH DT HOUSE PLANS APPROVED FOR BENNIPA O 'U JT GINTY; EDRGi�E�" Ph r l t, Ps ReS' Deuce .r,� �a.Qe. sha�c /ed• Signature & Ti -5 V ri 93 v ro DEPARTMENT OF HEALTH Division Of Environmental Health Services 110 Old Route Six Center, Carmel, New York 10512 (914) 225- &10ober 23, 1991 Mr. T. Michael Daly Box 243 Shenorock, NY 10587 JOHN KARELL Jr., P.E., M.S. Public Health Director Re: Proposed addition Jeffrey B.Stefannie Stien Lake Shore Drive (T) Putnam Valley TM (114 -1 -11 Dear Mr. Daly: I have received and reviewed the plans for the proposed addition to the above mentioned residence. The plans indicate that a 13' x 24' second story addition, will be added to the existing residence. The proposed addition represents an increase of approximately 15%. Therefore, based on the information submitted, the above mentioned addition is APPROVED with the following conditions: _i._..The. total. number of bedrooms must..remain.at three without prior approval by this s 2. The area of the existing sewage disposal system, and its expansion area, must be maintained. 3. All plumbing fixtures must be replaced or updated with water saving devices, i.e., low flush toilets, restrictors for shower heads and faucets, etc. Approval is granted for sewage disposal only. Any other permits or variances required are the responsibility of the applicant and the jurisdiction of the Town of Putnam Valley. If you have any questions, please contact me at your convenience. WH /jp cc: BI (T) Putnam Valley Very truly yours, William Hedges Sr. Public Health Sanitarian ar IF � I i Lac �a� i� %r�;7► �p►.1 �o i pp l,11 IGC? f '•�G'lA ` I S • �� OF Nf IY } foe A °• 048680 f,'�ti pOEE S 510ti�'� GJ l 5 °- T'J �j ` Zp �^� i "l 3 •'12 1'�q� `� llo�,.]►►1 c� ��oC�o2�fl Q'v�rr� od �T�D�A�� �l�.t� • . .:� .. 1c�Tnloz .co- Su�-a��►5►0►.►o�SZor�... yBuaKi•�'� 1 �Mtso-�,oa TK 4 ►+1L7 `' �-Ai S CAI 4�!�PA�LGC7' OM Lj �FORt�Ai10►► .111 7 03TT.�► O FtzOM ScL�zIIVG`! t_ DES - - - - - - - - - - I �n � I ME Zc PUMAUCCUMMIMAMMOMOVULUM Dhli..[2&ekea.a.w Bale swwlm . Cal" N.T. ion �naor M sabvli lhwllt fa CXRTRG►ZS OF Print ! «- " ?© POT li0� SiwAM OSiFOSAi. S� .... ..,... 9:._., �,` _ .. \ V . FEW S�atw. xa.. A nJ G Lot i �54- MT. Mop +•� � , K �: Z a84 M� O..w /Appraa.t x... INJ Deis of Approval lfdlat Ad&= -D \:JL-;,- T"E v'1 i�/ at-- t c)'S�G patc d Z Fee Enclosed Lot Ana 12 4 A M Sobl.. O.a LJ Dva Ydoo llattiae ft 1a +O� ✓✓J/ — Daolp nm G P D PC= to 1s4il" WYr M in Will~ oven" S& WOW **= r no" of Sap* Took .cent Adlleda Waw srin p SW4 pr.. Adber 1 /eprMNrt that 1 am wholly and CMVWehr responsible for the desyn and tiocation of the proposed systern(gi 1) that them Ywaaa dispoYl system above described will be constructed as shown on the approved amendrnent there to and in accordance with the standards6 rules and r"u ns O CdwKy Depart~ of pfolth. and that on completion thweof a'*C"fkato of Construction Compliance" Ytisfectory, to the Commi sldnw of llealthwill be laillaittsd to the DdpMtmwlt. and a written fillarantw will be furnished the owner. his SwAMMf. hews Or a y the WNW. that Yid bvNdw will Place M ~ Opwatbq condRbn. any pest of Yld mweN disposal system durinii the period of two (2) years tear followinb thedats of the Wau- a11e1 of the "WOW of the Cwtilkate of Construction Compliance of the or en or any opal" It i 2) het the drilled well described above WIN be bested as ahawn am apprewd pMn and that Yb west will be In wR stands ru and reM�Of the Putnam Oc �Ky o �'r'afe� 90 /a) I ddreY 2 G� License N0,���T 7Y� C APPROVED FOR CONSTRNCT10Ni ThM approval expires two years from the date Imu" whom construction of he brrildinp has been undertaken and is fea0e Ie for %sues or nay be anandad or nroditiod when con~od nsesu ry by the Commissioner of MeaRh. Any charge or aRwatbn of construction resrrwas a new permit.. Approved for dlspesat of demettic sanitary oewas"WOr pMate water supply only. �0%8Q 5 A . fA ;q 2- LAgt, s� ge.,- m Vc/ A"M16VID Pon ccmTau=GaQ4, v%ft epp'smi (:jfMW(M vwv-e)— r tho datO 42MAd UnOM UMMUC1100 of the Wilding Nis bftn undWUk4M and is govem" fG7 mm w My so DSM= op w6wigou ry by tho 18550= 09 HWltk Any C%SMO Of altaratiOn of C*r4rtWtWn fewdros a .. Amm;=3 gw (Sw=1 of oamicahc a 07 0 wata cumor only. Rev.. / 71711, L, rZ Ott - -k.,- TOM PUMANCOUMDEMIAMOMMMEAKM ohm= dmkwbuwdmw sods Sessions. CMM,4 X.T. low an C I RTWMWWA I F XA VA" TUN" wa Deftedhes Appim"d T. �4WF- ly�7yb & up Fee Enclosed l:3 Amniint, agaba Ty"fin 12a--3n AIL- -- IM Am i5 FWS"=0* LJ D.Fa vag,,, woobw III 5668=09- r7-,- . Doolp Flow OF -n 4<, o -- � PM Nomb"M is Recink" Wales, M b "Wel"od $wompi, armillow S."Aing to assaim d- 093I.M. S",ft Teak MW OZ, -ZA To be assaftevied,by Wallis, P4= Sneglb PbaW Ad6ses On n 13 DiSed by -f:f(t_t _,/ Froprisim t that I am wholly MW completely responsible for the dnqn and location of the proposed system(s); 1) that the W eta sser di YI stem above described will be constructed as shown on the approved amendment there to and In accordance with the standards, rules ey .0"Inty 08portment of Ha nh. and that on compWIM.thorsof a "Certificate, of Construction Compliance" satislact to the Commissioner of Hmuftwin be submitted to the Deportmailt. and a written quarastes will be furnished the owner his suecassor% hews or a the builder. that said launder win place in Sood.operaling co"Uwn. my Part of sells s@wW all v —1 system during the Period at two (2) VOWS sly following thiligets, of the mew moo of the approval of the Certificate of Const►uctilm Compliance of the original System or 8"'ropoirs t 12 t drused w" downs" 060" wO be Wanted as Shibra so the approvoill Man and that Uld won will be Instal &cCV with SUMB ru a ree—UMMrs-3f the Putnam County We Sip"d :Ilk A F49 Q4 ZA License No APPROVED FOR COMTRUCTI044i This approval expires rom the date Issued unless construction of t building has boon undertaken and is. so fe�rcsqT or may be SWARded of M"Ifled when 0!!! ----ry by the lasioner of Health. Any change or siteration of construction WoallNO K Approves! fir disposal of domestic Im a W water supply only. Itiv, 19/80. e� / By Title L� PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION. OF., ENVIRONMENTAL --HEAL_TH... SERVICES Date OG"TD��it2 Re: Property of Located at (T)N VI�I.Ii� TM i Block 2 Lot 5 pn Subdivision of ROMF-4 -1 j t3� Subdv. Lot # �T Filed Map ## Date SIT- MICHAEL DALY, P.E. Gentlemen • CONSULTING ENGINEER P. 0. BOX 243 This letter is to authorize SHENOROCX, N. Y. 105x7 a duly licensed professional engineer 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 Department of Health, and to sign all necessary papers on my behalf in connection with--this matter and to supervise -the _const,ru t. •on.. of, ��� d. system or systems in conformity with the provisions of Article,.„,.;1451or 147, Education Law, the Public Health Law, and the Putnam County aril terry Code. Countersigned: P.E., R.A. , # A8it4pt) T. MICHAEL DALY, P.E. Address e0N3ttT11qG ENGINEER P. 0. BOX 243 SHENOROCK, N. Y. 10587 (6)1 A-) (oZ5 -6 5� - Telephone Very truly yours, = Signed 47� La I A,er of RFopertt 55 i"-E- 5 oR+.►� Address 1 i4NA VAWE>() 41ew `(oil- 105 -79 Town Telephone •e . DEPARTMENT.OF HEALTH Division of Environmental Health Services 110 OLD ROUTE SIX CENTER CARMEL N Y 10512 (914) 225 -0310 f f ". � .,i:- .�' .'_ -: obis..-,..., y-.., v_ �-_...-... r..-.,.....,, �...:,. 7 ..,.,_.._.a:a.:.- ,-= ...,rm_�.,; APPLICATION TO CONSTRUCT A WATER WELL PCHD PERMIT # WELL LOCATION Street Addre s Town Village City Tax Grid Number WELL OWNER Name Mailing Address APrivate UAL O Public USE OF WELL 1 - primary .2 - secondary MIRESIDENTIAL ®PUBLIC SUPPLY OAIR /COND /HEAT PUMP 13ABANDONED 0 BUSINESS O FARM O TEST /OBSERVATION O OTHER (specify, ® INDUSTRIAL P INSTITUTIONAL O STAND -BY AMOUNT OF USE YIELD SOUGHT_ I�gpm /# ®REP ,ACE EXISTING SUPPLY W. SVPPLY (NEW-DWELLING) S PEOPLE SERVED -4—' /EST. OF DAILY USAGE_cs_E!)0 gal ® TEST/ OBSERVATION 13 ADDITIONAL SUPPLY O DEEPEN EXISTING-WELL REASON FOR DRILLING DETAILED) REASON FOR DRILLING WELL TYPE IlDtLLED DRIVEN ®DUG GRAVEL OTHER IS WELL SITE SUBJECT TO FLOODING? YES IF WELL LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION: Lot WATER.WELL.CONTRACTOR:- Name Address: IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES ✓/N� NAME OF PUBLIC WATER SUPPLY: TOWN /VIL /CITY DISTANCE TO PROPERTY FROM NEAREST WATER MAIN: LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED SEPARATE SHEET 10114 L2�2 (date) (s 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 5'of the New York State Sanitary Code, and provided that within thirti� (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 otherwise contaminate surface or groundwater. Date of Issue: ,G` c� �- 19 �� Date of .Expiration 19 / e'" Permit Issuing Offic Permit is Non - Transferrable White copy: HD File Pink copy: Owner 3/89 Yellow copy: Bldg. Insp. Orange copy: Well Driller PUTNAM COUNTY DEPARTMENT OF HEALTH OF UXVI RQ N -L-Z TJHL-MRKKI��Jv-a-,�- -NMB1A ZAL Date (0 1 � q o Re: Property of Located at r - /6- ,A?%7 (T) 77 Block Subdivision of -10. Lot Subdv. Lot # Filed Map # Date Gentlemen; T. MICHAEL DALY, P.E. CONSULTING ENGINEER This letter is to authorize P. 0. BOX 243 3-a-ENORA K, N. T. 10567 a duly licensed professional engineer 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 Department of Health, and to sign all necessary papers on my behalf in connection with;. this- matter, and. supejrjyise, the ,construe .-tIon 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. Countersigne P.E., R.A., � Very truly yours, X -W-- QN.A.-1 BAEY- Address CONSULTING ENGINEER P. 0. BOX 243 CFjV%TApqrq Telephone gned Address yu�wm\"W !0SY7q Town Telephone Le-J." owe R54 V41:4 6 15 Nac go B-.10""Z12y V.1 M; I Pg." hy 4 -1 a-11RWA-0i M DESIGN DATA SHEET-SUBSUFACE SEWAGE DISPOSAL SYSTEM FILE NO.- Owner Address Kk"EF- OE�- Located at (Street)- Block Lot (indicate nearest cross street) municipality IWatershed 2AN-21,W4 TO BE SUBMITTED W-vill APPLICATIONS Date of Pre-Soaking 2 1 to [� o Date of Percolation Test - I l I t Lk 0 HOLE NUMBER C= TIME PERCOLATION PERCOLATION Run Elapse Depth to Water Fran Water Level No. Time Ground Surface In Inches Soil Rate Start-Stop Min. start stop Drop In Min/In Drop Inches Inches Inches i o- g 15-- 2 Q 1,0 1 q I 15- 3 0 15 Is 12 l 15 4 5 t 2 C3- 3 0 15' 4 5 1 2 3 4 5 NOTES: 1. Tests to be repeated at same depth until approximately equal soil rates are obtained.at each percolation test hole. All data to'be submitted for review. 2. Depth measurements to be made frcm top of hole. rev. 9/85 TEST PIT DATA REQUIRED TO BE SUBMITTED WITH APPLICATION DESCRIPTION OF SOILS ENCOUTMED IN TEST HOLES G.L. 1' 2' 3' 4' 5' 6' 7' 8' 9' 10' 11' 12' 13' 141 INDICATE LEVEL AT WHICH GROUNDWATER .IS ENCOUNTERED INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED.. DEEP HOLE OBSERVATIONS MADE BY: DATE: DESIGN -- Soil Rate Used �l -��,— Min /1" Drop: S.D. Usable Area Provided ° VeT,1 p No. of Bedroans „ a Septic Tank Capacity j gals. Type N Absorption Area Provided By °� S'� L.F. x 24" width Other Name _ �d Y l.0 [-� R i I '(�^ Signatur" z �10 ern Address ''' �'3 SEAL - QhF'siora��'` THIS SPACE FOR USE BY HEALTH.DEPARTMFNP ONLY: Soil Rate Approved sq.ft /gal. Checked by Date PU'INAM COUNTY DEPARTMENT OF HEALTH - DIVISION OF ENVIRONMENTAL HEALTH SERVICES INDIVIDUAL WATER SUPPLY & SUBSURFACE SEWAGE DISPOSAL SYSTEMS REVIEW -SHEFT - 'CCNS1Rt1CI'I0N PEPSUT --�- c DA (Name of Owner) (Street Location) COMMENTS YES NO \ ��r % LF trench providedC� required 2 0 ft. max. 6-'J Parallel to contours 100% exp. FILL SYSTEMS cla barrier 10 ft. fill notes new spec. depth gauges 100 r. flood elev. 200 ft. reservoir, etc. 150 ft. trigall /gall. e. P l DOCUMENTS Permit Application Corporate Resolution Plans - Three sets Engineers Authorization Design Data Sheet (DDS) Deep Hole Log Consistent Perc Results Perc Hole Depth lans - Two sets Wel permit; FWS letter Variance Request C=F:NF`R AL Legal Subdivision Subdivision Approval Checked Ex- approval SSDS Adj. Lots Checked Wetland ( Town /DEC Permit R & D) Data On DDS Plans & Permit Same REQUIRED DETAILS ON PLANS Sewage System Plan - (north arrow) Swage System Hydraulic Profile - Gravity Flcw Fill P cfile & Dimensions - Volume D o��ax;Trench /Gallery; Pump pit details Septic Tank - Size, Detail Well Detail, Service Line if over Construction Notes (grinder rate)_ Design Testa: �aerc 'arid deep results Two -Foot Contours Existing & Proposed Driveway & Slopes Cut Footing/Gutter,Curtain Drains (discharge OK) Perc & Deep Holes Located Representative of primary and expansion Expansion Area; shorn; gravity flow, Buff : size If Punped Pit & D Box Shown & Detailed House - No. of Bedrooms Wells & SSDS's w /in 200 ft. of Proposed Systems Property Metes & Bounds House Setback Necessary (Tight lot) House Sewer - 1 /4 " /ft. 4 "0; Type pipe No Bends; Max. Bends 45° w /cleanout SEPARATION DISTANCES SPECIFIED ON PLAN Fields 10' to P.L., Driveway, Large Trees,Top of fill 20' to Foundation Walls 100' to Well; 200' in D.L.O.D, 150' pits 100' to Stream, Watercourse, Lake (inc. expan) 15' to Drains-Curtain, Leader, Footing 351to catch basin,storrrdrain,piped watercourse 10' to Water Line (pits -201) 50' intermittent drainage course Septic Tanks 10' from Foundation; 50' to well 15' Well to PL 9 DATE ;REEVI� s/s SUBDIVISION Perc (3) Fill cd