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HomeMy WebLinkAbout0059 REGATTA DRIVE - Health (2) _ _ . _ _ - __- _ _ _ a.�a J os ► � �� _ _-- - _ ._ �, �� !,, � 3z APPLICATION FOR PERCOLATION .. . ,. CATION . . MAND ..' B S'�.A0 ERVATION PITSLOCATION +I�V�, COPS , Lpr jA�'rQ ��l`V� VILLAGE a/ NYA- ots C NO, F V t l,�� � NDATE 'APPLICANT l �✓ FEE 411,- \ADDRESS 1 ' TELEPHONE No. 77)-1D� (Non-refitndablE ENGINEER TELEPHONE N0. '4•z8-9i31 DATE: SCHEDULED;.:' (Applicant' s signature) ,,ASSWo*'S�b1AF'�8i LOT NOi SOIL LOG > SUB-DIVISION NA1dE s DATE E} PINSION ARLA ✓ `r �.. Y ETNIGDS_IE N �E�ER� :' Q'TOWN: PATER ✓PRIVATE WELL ' y Vr syk+ s !L(Si.C� BOARD OF HEAL? EXCAVATOR SKETCH T(Street `name etc. ,dimensions , of lot, exact''location of 'test holes -and percolation tests, locate wetlands in proximity to test holes) NOTES: S4, � is �IV PERCOLATION :RATE V14 .4 AA TEST HOLE NO,:" ELEVATION: __�____ 1 TEST HOLEN0: ELEVATION: 2 L.-+C; 1 4 . �C� 3 5 �t�tll fr-r ah. 4 6 New SAMa 6 8 mtz �AIJa a . 9 &aAVLzL_ 9 to /vl 10 ` 11 •r �, ri.n.,it:5»`� rt r `1."T ,el ,�' .Ai.:t; ,�tss la✓. -.t•,"� ., r _... h:�-.:11 M. ..,...iY41.P u._�=° , r. "�.Y.x. w,s7'f.K..,,:o^?r�'*4:Yayk;"�'_rn'�� f ,. ..,. 12 ' 12 13. 13 14 •16 ., . . 15 , 6 E ; SUITABLE .TOR_,SUB-SURFACE SEWAGE LEACHINGIFIE LD LEA C NG PITS A LEACHING TREN:CHESz_� UNSUITABLE FOR` SUB=SURFACE SEWAGE. REASONS: NOTE: ` ;ENG•INEE�RING. PLANS 14UST SHOW NUMBER• ASSIGNED .ON PERC TEST APPLICATION ORIGINAL': CO14PLETED TN ENTIRETY p COPY: RETAINED BY APPLICANT RNED TO BOARD OF HEALTH .. ..., '• ...s :are ._ •ss. -,t.+' --• -. ,