N.H. Admin. Code § We 602.17

Current through Register No. 50, December 12, 2024

Section We 602.17 - Setback Reductions: Setback Reduction Form

A "Setback Reduction Form" shall contain the following:

(a) Name of property owner;

(b) Location of property, including, as applicable; and

(1) Street address;

(2) Subdivision name and lot number; and

(3) Town tax map number and lot number;

(c) Reason for alternate location;

(d) If applicable, methods of construction used for construction of wells with reduced setbacks, as specified in We 602.14;

(e) A sketch map of the on lot well location indicating exact distances to at least 3 permanent reference points;

(f) The actual setback distances from the alternate location to potential observed sources of contamination, including but not limited to:

(1) On-site and off-site septic system tanks and effluent disposal areas; and

(2) Property boundaries;

(g) The property owner's signature and date; and

(h) The water well contractor's name and license number.

N.H. Admin. Code § We 602.17

Derived From Volume XXXVII Number 2, Filed January 12, 2017, Proposed by #12083, Effective 3/1/2017, Expires 3/1/2027.