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COMMUNITY DEVELOPMENT DEPARTMENT Robert “Terry” Gilbert, AICP Director Comprehensive Planning Zoning Development Review Building and Safety Economic Development Code Enforcement SEPTIC APPLICATION L:\BUILDING DIVISION\Forms\APPs\BLDG-002 RESIDENTIAL SEPTIC BUILDING PERMIT APPLICATION.doc Page 1 of 12 Rev: 10/2006 GENERAL INSTRUCTIONS: Fill out this application in full. Do not leave blank spaces or your application may be refused Two percolation tests and a soil profile are required for each individual system you plan to install. The permit cannot be issued without good sound percolation data. Fees are due when the application is either submitted or at time of pick up. The fee for each individual system is $100.00. Please make checks payable to: “City of Fernley” GENERAL INFORMATION: Applicant: Mailing Address: City: State: Phone Number: PROJECT INFORMATION: Assessor’s Parcel Number: Lot Size: Subdivision: Zoning: Setbacks: Front Side Rear Corner Parcel Flood Zone: Number of Bedrooms in Dwelling: Distance from Property Line to Nearest Community Sewer (if applicable) WATER SOURCE: (Circle One) 1. Private Well 2. Public Water System Name of Public Water System: SEPTIC TANK: (See Page 7 for Size Required) Size: Manufacturer: Distance from Well: Distance from Nearest Neighboring Well(s): Distance from Foundation of Dwelling: ---PAGE BREAK--- COMMUNITY DEVELOPMENT DEPARTMENT Robert “Terry” Gilbert, AICP Director Comprehensive Planning Zoning Development Review Building and Safety Economic Development Code Enforcement SEPTIC APPLICATION L:\BUILDING DIVISION\Forms\APPs\BLDG-002 RESIDENTIAL SEPTIC BUILDING PERMIT APPLICATION.doc Page 2 of 12 Rev: 10/2006 LEACH FIELD: (See Page 7 to Determine Length) Distance from Well: Distance from Nearest Neighbor(s) Well: Number of Lines: Length of Each Line: Trench Width: Distance between Lines: Depth of Trench before Rock is Placed: Amount of Rock you are Installing under Each Pipe: Over Each Pipe: CHAMBER SYSTEM: (See Page 8 for Sizing) Distance from Well: Distance from Nearest Neighbor(s) Well: Number of Lines: Total Developed Length of Chambers: Depth of Trench (Bottom of Chamber): COVER MATERIAL: (Circle One) 1. Untreated Building Paper 2. Filter Fabric 3. Straw 4. Uncovered INSTALLER INFORMATION: Who is installing this Septic System? If Applicant in Not Installer, Please Provide: Nevada State Contractors License Number: City of Fernley Business License number: Address: City: State: Phone Number: WELL INFORMATION: NOTE: The Well must be drilled prior to Final Septic Inspection. Well Construction: Diameter: Depth: Casing Depth: Well Contractor: Address: City: State: Owner/Contractor Signature: Date: ---PAGE BREAK--- COMMUNITY DEVELOPMENT DEPARTMENT Robert “Terry” Gilbert, AICP Director Comprehensive Planning Zoning Development Review Building and Safety Economic Development Code Enforcement SEPTIC APPLICATION L:\BUILDING DIVISION\Forms\APPs\BLDG-002 RESIDENTIAL SEPTIC BUILDING PERMIT APPLICATION.doc Page 3 of 12 Rev: 10/2006 PLOT PLAN INFORMATION: (NAC 444.784) The Following Items shall be shown on the Plot Plan: (use page 4 to draw plot plan) 1. Location as to roads and streets. 2. Location and distance to well and sewage systems on surround lots (if vacant, so indicate). 3. Direction of North clearly indicated. 4. The distance to any watercourse (pond, lagoon, stream, irrigation ditch or drainage ditch) within 500 feet. 5. The location of the percolation test sites and the soil profile test pit must be shown on the plans. 6. The location and depth of the well (existing or proposed). Indicate the depth of the casing or surface grout seal. 7. All septic system components must be properly marked and located at the specified distances. 8. The distance to community sewerage. If none, so indicate. 9. Distance of septic system components and well to the property line. 10. Plans must be drawn to scale (1 inch = 30’, 40’, 50’, etc.) 11. The capacity of the septic tank. 12. The maximum slope across the absorption system (leach field) area. 13. Lot dimensions. 14. Depth, length and width of trenches and distance between trenches (between center lines of trenches). 15. Water supply lines and sewer lines. 16. Location of all structures, paved areas and areas of vehicular traffic. ---PAGE BREAK--- COMMUNITY DEVELOPMENT DEPARTMENT Robert “Terry” Gilbert, AICP Director Comprehensive Planning Zoning Development Review Building and Safety Economic Development Code Enforcement SEPTIC APPLICATION L:\BUILDING DIVISION\Forms\APPs\BLDG-002 RESIDENTIAL SEPTIC BUILDING PERMIT APPLICATION.doc Page 4 of 12 Rev: 10/2006 PLOT PLAN ---PAGE BREAK--- COMMUNITY DEVELOPMENT DEPARTMENT Robert “Terry” Gilbert, AICP Director Comprehensive Planning Zoning Development Review Building and Safety Economic Development Code Enforcement SEPTIC APPLICATION L:\BUILDING DIVISION\Forms\APPs\BLDG-002 RESIDENTIAL SEPTIC BUILDING PERMIT APPLICATION.doc Page 5 of 12 Rev: 10/2006 Soil Test Pit #1 Soil Test Pit #2 Date of Test Date of Test Depth in Feet Soil Texture Depth in Feet Soil Texture Depth to Groundwater Depth to Groundwater NAC 444.796 Performance of percolation test by property owner; verification of certain data by engineer. (NRS 439.200, 444.650) 1. Data from percolation tests from a minimum of two test holes in the area of the proposed soil absorption system is required. The property owner shall perform a percolation test in accordance with this section and NAC 44437962 to 444.7968, inclusive. 2. The hole must be dug or bored to the proposed depth of the absorption trench. The hole must have vertical sides and have a horizontal dimension of 4 to 12 inches. The bottom and sides of the hole must be carefully scratched with a sharp-pointed instrument to expose the natural soil interface. All loose material must be removed from the bottom of the hole which must then be covered with 2 inches of coarse sand or gravel when necessary to prevent scouring. Any soil which has sloughed into the hole before or during the percolation test must be removed. ---PAGE BREAK--- COMMUNITY DEVELOPMENT DEPARTMENT Robert “Terry” Gilbert, AICP Director Comprehensive Planning Zoning Development Review Building and Safety Economic Development Code Enforcement SEPTIC APPLICATION L:\BUILDING DIVISION\Forms\APPs\BLDG-002 RESIDENTIAL SEPTIC BUILDING PERMIT APPLICATION.doc Page 6 of 12 Rev: 10/2006 Percolation Test #1 Percolation Test #2 Performed By Performed By Time Time Interval in Minutes Measurement s in inches Drop in water level in inches Percolation rate in minutes per inch Time Time Interval in Minutes Measurement s in inches Drop in water level in inches Percolation rate in minutes per inch Percolation rate = minutes per inch (Divided time interval in minutes by drop in inches) Percolation rate = minutes per inch (Divided time interval in minutes by drop in inches See pages 11 and 12 for Percolation instructions. ---PAGE BREAK--- COMMUNITY DEVELOPMENT DEPARTMENT Robert “Terry” Gilbert, AICP Director Comprehensive Planning Zoning Development Review Building and Safety Economic Development Code Enforcement SEPTIC APPLICATION L:\BUILDING DIVISION\Forms\APPs\BLDG-002 RESIDENTIAL SEPTIC BUILDING PERMIT APPLICATION.doc Page 7 of 12 Rev: 10/2006 3 or less bedrooms 1000 gallon tank 4 bedrooms 1200/1250 gallon tank 5 or 6 bedrooms 1500 gallon tank Feet of gravel below leach pipe Feet of gravel below leach pipe Feet of gravel below leach pipe 1 ft 2 ft 3 ft 1 ft 2 ft 3 ft 1 ft 2 ft 3 ft Perc rate (min/in) Lineal feet of leach trench Lineal feet of leach trench Lineal feet of leach trench 0-10 312 156 104 375 188 125 469 235 156 11-15 384 192 128 462 231 154 577 289 192 16-20 454 227 151 545 273 182 682 341 227 21-25 500 250 167 600 300 200 750 375 250 26-30 556 278 185 667 333 222 834 417 279 31-40 625 312 208 750 375 250 938 469 313 41-50 714 357 238 857 [PHONE REDACTED] 536 357 51-60 835 [PHONE REDACTED] [PHONE REDACTED] 625 417 If the percolation rate of the soil is greater than 60 minutes per inch, the system must be designed by an engineer. ---PAGE BREAK--- COMMUNITY DEVELOPMENT DEPARTMENT Robert “Terry” Gilbert, AICP Director Comprehensive Planning Zoning Development Review Building and Safety Economic Development Code Enforcement SEPTIC APPLICATION L:\BUILDING DIVISION\Forms\APPs\BLDG-002 RESIDENTIAL SEPTIC BUILDING PERMIT APPLICATION.doc Page 8 of 12 Rev: 10/2006 SEPTIC TANK SIZES 1000 Gallon Tank 3 Bedrooms or Less 1250 Gallon Tank 4 Bedrooms 1500 Gallon Tank 5 or 6 Bedrooms Equalizer 24 1.5' Wide Trench Quick 4 Equalizer 36 2' Wide Trench Equalizer 36 2' Wide Trench Quick 4 Standard 3' Wide Trench Standard and Standard Sidewinder 3' Wide Trench High Capacity Sidewinder 3' Wide Trench Equalizer 24 1.5' Wide Trench Quick 4 Equalizer 36 2' Wide Trench Equalizer 36 2' Wide Trench Quick 4 Standard 3' Wide Trench Standard and Standard Sidewinder 3' Wide Trench High Capacity Sidewinder 3' Wide Trench Equalizer 24 1.5' Wide Trench Quick 4 Equalizer 36 2' Wide Trench Equalizer 36 2' Wide Trench Quick 4 Standard 3' Wide Trench Standard and Standard Sidewinder 3' Wide Trench High Capacity Sidewinder 3' Wide Trench Percolation Rate (min/in) 15" W 8.33' L 22" W 4.0' L 22" W 8.33' L 34" W 4.0' L 34" W 6.25' L 34" W 6.25' L 15" W 8.33' L 22" W 4.0' L 22" W 8.33' L 34" W 4.0' L 34" W 6.25' L 34" W 6.25' L 15" W 8.33' L 22" W 4.0' L 22" W 8.33' L 34" W 4.0' L 34" W 6.25' L 34" W 6.25' L 10 or less 17 30 15 26 18 15 22 37 18 32 22 19 26 45 22 38 27 23 11-15 21 37 18 32 22 19 27 46 22 39 27 24 32 55 27 47 33 28 16-20 25 43 21 37 26 22 31 54 26 46 32 28 37 65 31 56 39 33 21-25 25 48 23 41 28 24 34 60 29 51 35 30 41 71 34 61 42 36 26-30 31 53 26 45 32 27 38 66 32 57 39 34 46 79 38 68 47 40 31-40 34 60 29 51 35 30 43 74 36 64 44 38 51 89 43 76 53 45 41-50 39 68 33 58 40 35 49 85 41 73 50 43 59 102 49 87 60 52 51-60 46 79 38 68 47 40 57 99 48 85 59 50 68 119 57 101 70 60 Minimum number of chambers required per dwelling is 15 chambers. Please refer to sizing chart. CIRCLE OR HIGHLIGHT YOUR SELECTION ---PAGE BREAK--- COMMUNITY DEVELOPMENT DEPARTMENT Robert “Terry” Gilbert, AICP Director Comprehensive Planning Zoning Development Review Building and Safety Economic Development Code Enforcement SEPTIC APPLICATION L:\BUILDING DIVISION\Forms\APPs\BLDG-002 RESIDENTIAL SEPTIC BUILDING PERMIT APPLICATION.doc Page 9 of 12 Rev: 10/2006 SET-BACK INFORMATION: Minimum horizontal distance in clear, required from: Building sewer drain Septic Tank Disposal Field (shallow) Building or structure 8’ 8’ Property lines 10’ 10’ 10’ Public water supply wells 50’ 150’ 150’ Water supply wells sealed to 50’ 50’ 100’ 100’ Water supply wells not sealed to 50’ 50’ 100’ 150’ Streams or watercourse 50’ 100’ 100’ Drainage channels 25’ 25’ 25’ Large trees or shrubs 10’ 10’ Disposal (leach) fields 5’ Community water main line 10’ 10’ 25’ Individual water service line 10’ 10’ 25’ Dry wells 6’ 20’ If additional information is required, please contact: ---PAGE BREAK--- COMMUNITY DEVELOPMENT DEPARTMENT Robert “Terry” Gilbert, AICP Director Comprehensive Planning Zoning Development Review Building and Safety Economic Development Code Enforcement SEPTIC APPLICATION L:\BUILDING DIVISION\Forms\APPs\BLDG-002 RESIDENTIAL SEPTIC BUILDING PERMIT APPLICATION.doc Page 10 of 12 Rev: 10/2006 TYPICAL SEPTIC SYSTEM TYPICAL TRENCH ---PAGE BREAK--- COMMUNITY DEVELOPMENT DEPARTMENT Robert “Terry” Gilbert, AICP Director Comprehensive Planning Zoning Development Review Building and Safety Economic Development Code Enforcement SEPTIC APPLICATION L:\BUILDING DIVISION\Forms\APPs\BLDG-002 RESIDENTIAL SEPTIC BUILDING PERMIT APPLICATION.doc Page 11 of 12 Rev: 10/2006 NAC 444.7962 Determination of appropriate percolation test procedure. (NRS 439.200, 44.650) In Conduction a percolation test, the following flow chart must be used to determine which test procedure to follow: 1. Fill the percolation hole with water to a depth of at least 12 inches over the aggregate. Determine the time needed for the water to seep away completely. 2. Fill the percolation hole with water again to a depth of at least 12 inches over the aggregate. Determine if the water seeps away in 10 minutes or less. 3.a If water is left in the percolation hole after 10 minutes, proceed with the PRESOAKING PROCEDURE, followed by the SLOW PERCOLATION TEST PROCEDURE. 3 b If the water has completely seeped away after 10 minutes, proceed with the FAST PERCOLATION TEST PROCEDURE. NAC 444.7964 Fast percolation test procedure. (NRS 439.200, 444.650) The following flow chart illustrates the fast percolation test procedure: 1. Fill the percolation hole with water to a level that is no more that 6 inches over the aggregate. 2. From a fixed reference point, determine at 10-minute intervals how much the water drops over the next 60 minutes. If 6 inches of water seeps away in less than 10 minutes, a shorter interval between measurements must be used. 3. Refill the hole as necessary to prevent all water from seeping away. The level of the water must never exceed 6 inches in depth over the aggregate. 4. The amount of the drop in the level of the water recorded for the final 10-minute period must be used to determine the percolation rate. NOTE: The minimum time in which a fast percolation test may be completed is 1 hour. The level of the water must never exceed 6 inches over the aggregate during a fast percolation test. ---PAGE BREAK--- COMMUNITY DEVELOPMENT DEPARTMENT Robert “Terry” Gilbert, AICP Director Comprehensive Planning Zoning Development Review Building and Safety Economic Development Code Enforcement SEPTIC APPLICATION L:\BUILDING DIVISION\Forms\APPs\BLDG-002 RESIDENTIAL SEPTIC BUILDING PERMIT APPLICATION.doc Page 12 of 12 Rev: 10/2006 NAC 444.7966 Presoaking procedure for slow percolation test. (NRS 439.200, 444.650) The following flow chart illustrates the presoaking procedure for a slow percolation test: 1. Fill the percolation hole with clear water to a minimum depth of 12 inches over the aggregate. 2. Maintain at least 12 inches of water over the aggregate in the hole for 4 hours. 3. Any water remaining in the hole at the end of the 4 hour period must be allowed to seep away. Do not remove the water. 4. Let the hole sit for not less than 16 hours or more than 30 hours. Swelling of the soil will occur during this period. The SLOW PERCOLATION TEST PROCEDURE must begin no sooner than 16 hours and no later than 30 hours after the end of the 4 hour soaking period. NAC 444.7968 Slow percolation test procedure. (NRS 439.200, 444.650) The following flow chart illustrates the slow percolation test procedure: 1. Fill the percolation hole with water to a maximum depth of 6 inches over the aggregate. 2. From a fixed reference point, measure the drop in the level of the water at 30 minute intervals, for a total of 4 hours. If the first 6 inches of water seeps away in less than 30 minutes, the interval between measurements must be reduced to 10 minutes and the length of the test must be reduced to 1 hour. 3. Fill the hole to a maximum depth of 6 inches over aggregate as often as necessary to prevent the hole from becoming empty. 4. The amount of the drop in the level of the water during the last interval must be used to determine the percolation rate, except that if two successive measurements do not vary more that 1/16 inch, the test may be stopped and the percolation rate may be determined.