HomeMy WebLinkAbout0031 CONANT LANE - Health 31 CONANT LANE, CENTERVILLE
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UPC 12534 To
No. 2 153LOR �°usrcoc °
WASTiNGS. UN
TOWN OF BARNSTABLE
LOCATION l^r: ,:L / e, SEWAGE # — �- L
VIILLAGE S'F?.,i !r i j/ � ASSESSORS MAP & LOT_ 6 73-6 7 7
INSTALLER'S NAME&PHONE NO. /.?I I't l r `►.� r-G 7[ c
SEPTIC TANK CAPACITY /c
LEACHING FACILITY: (type) i.:✓�i/J"C Tomp�� (size) �/
NO.OF BEDROOMS__
BUILDER OR OWNER
I
PERMIT DATE: l�—COMPLIANCE DATE:
Separation Distance Between the:
Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet
Private Water Supply Well and Leaching Facility (If any wells exist
on site or within 200 feet of leaching facility) Feet
Edge of Wetland and Leaching Facility(If any wetlands exist
within 300 feet of leaching facility) Feet
Furnished by
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No. 7 a� • "s Fee /
,a THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS
21ppYication for Digoar *p5tem Construction Permit
Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) O Complete System -k1 dividual Components
Location Address or Lot No.'73 1 L --r 4Q\, �CEi`� Owner's Name,Address and Tel.No.
Assessor's Map/Parcel 2 i6-7 v T k K
Installer's Name,Address,and Tel.No. �f Designer's Name,Address and Tel.No.
�V�-oo, so-(�ttC
Type of Building:
Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( )
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow ��✓-O gallons per day. Calculated daily flow 3 � gallons.
Plan Date Number of sheets Revision Date
Title it
Size of Septic Tank -- nn 't 60G10 14 Type of S.A.S. c G L
Description of Soil
Nature of Repairs or Alterations(Answer when applicable) Q—
Date last inspected:
Agreement:
The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system
in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi-
cate of Compliance has be o
Signed Date
Application Approved by Date
Application Disapproved for the folio ' g reasons
Permit No. Date Issued
Qr,
No. / 7 ^ � � .�:4 l Fee -
/
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
Yes
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS
4-
application for Migpogaf *pgtem Congtruction Permit
Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) ❑Complete System W'htdividual Components
Location Address or Lot No.3 k COVC1111 C" Cev,:Q—t�.C_rl_�' Owner's Name,Address and Tel.No.
Assessor's Map/Parcel ,/� �/ V r
Installer's Name,Address,and Tel.No.l (J Designer's Name,Address and Tel.No.
�51 vet S s�-
Type of Building:
Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( )
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow O gallons per day. Calculated daily flow _3�� gallons.
Plan Date Number of sheets Revision Date
Title
f Size of Septic Tank c u. CYO lA c Type of S.A.S. <
Description of Soil _
Nature of Repairs or Alterations(Answer when applicable)
Date last inspected:
Agreement:
The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system
in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi-
cate of Compliance has be��assaed-by tfris-13. o
Signed a Date
Application Approved by .r Date /i- - S
Application Disapproved forth ollo g reasons r s
3
Permit No.�/ '� I Date Issued
---------------------------------------
THE COMMONWEALTH OF MASSACHUSETTS
r- BARNSTABLE, MASSACHUSETTS
Certificate of Compliance
THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed( ) Repaired( )Upgraded(K<
Abandoned( )by b
3
`t at , has been constructed in accordance
with the provisions of Title 5 and the for Disposal System Construction Permit No. E dated
Installer Designer
The issuance of this permit shall not be construed as a guarantee that the system ill function as designed.
Date - _ Inspector
b ---------------------------------------
No. r Fee
i'
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS
Migpogal *pgtem Congtruction Permit
Permission is hereby granted to Construct( )Repair( )Upgrade
System located at
and as described in the above Application for Disposal System Construction Permit. The applicant recognizes his/her duty to
comply with Title 5 and the following local provisions or special conditions.
Provided:Construction must be completed within three years of the date of this permit.
CN i
Date: q — !/ 1 (= Approved by 0 �
-o'
1/6/99
NOTICE: This Form Is To Be Used For the Repair Of Failed
Septic Systems Only. -
CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL
WORKS CONSTRUCTION PERMIT (WITHOUT DESIGNED PLANS)
M b-71
I, L\S , hereby certify that the application for disposal works
construction permit signed by me dated concerning the
property located at 21 Ct)a.,0_61� laI4.0_ '���ec�.ti«P meets all of the
following criteria:
tZ The failed system is connected to a residential dwelling only. There are no commercial or business
uses associated with the dwelling.
• The soil is classified as CLASS I and the percolation rate is less than or equal to 5 minutes per inch.
There are no wetlands within 100 feet of the proposed septic system
CI-Alere are no private wells within 150 feet of the proposed septic system
• /There is no increase in flow and/or change in use proposed
C/, •where are no variances requested or needed.
C /The bottom of the proposed leaching facility will not be located less than five feet above the
ma.dmum adjusted groundwater table elevation. (Adjust the groundwater table using the Frimptor
method when applicable]
( the S.A.S. will be located with 250 feet of any vegetated wetlands, the bottom of the proposed
leaching facility will not be located less than fourteen(14)feet above the maximum adjusted
groundwater table elevation,
Please complete the following:
A) Top of Ground Surface Elevation(using GIS information)
B) G.W. Elevation +the MAX High.G.W. Adjustment.
DIFFERENCE BETWEEN A and B o
SIGNED : i DATE: -8 S
[Sketch proposed plan of system on back].
q:health folder:cert
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oT y7 TOWN OFBU!? STABLE F p�
Li-,)CATION I cr,L,4-7' 4, SEWAGE #
VILLAGE .. 1 e-r-izi 1, ASSESSOR'S MAP & LOT 2�L-0 2
INSTALLER'S NAME&PHONE NO.
SEPTIC TANK CAPACTITY
LEACHING FACIL=: (type) /.,V ��/' r� (size)
NO.OF BEDROOMS_
BUILDER OR OWNER ip1
PERMIT DATE: ,l-SbCOMPLIANCE DATE: -%2
Separation Distance Between the: .
Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet
Private Water Supply Well and Leaching Facility (If any wells exist
on site or within 200 feet of leaching facility) Feet
Edge of Wetland and Leaching Facility(If any wetlands exist
within 300 feet of leaching facility) Feet
Furnished by
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THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEAL "
UW:'1.....................OF........ f"7. �'------. le....._.-.._-..............
ApplirFation for Dispm al Works Tomitrnrtinn JIrrmit
Application is hereby made for a Permit to Construct (/or Repair ( ) an Individual Sewage Disposal
j System at:
.. .................................�/Loc lion-Address r'^ r N.
... - �.°..un . v.�t �� ...... � pe�� 1 r?� f»». ......__ y .........».....
t V i l��clOwner Address
-- l. ------- �- .....__.../ •---.------•. .........................
Installer Address
Type of Building Size Lot.. ¢_ . ....Sq. feet
U Dwelling—No. of Bedrooms_._....../!ate.....................Expansion Attic (� Garbage Grinder ( )
'4 Other—Type T e of Building �? __.. No. of ersons.........---......_.__.. Showers p., yp g ------�-1--- p ( ) — Cafeteria ( )
a' Other fixtures .............:-�..........................
W Design Flow........... ..................gallons per person per day. Total daily flow.:......,; _. .....................gallons.
WSeptic Tank—Liquid capacity/x,*,0.Qgallons Length.......6_..... Width..&........ Diameter................ Depth.................
x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft.
Seepage Pit No----------_--------- Diameter.................... Depth below inlet..................... Total leaching area..................sq. ft.
Z Other Distribution box ( ) Dosing ta-,, ) q s 7
Percolation Test Results Performed by...._.__'/./'_, _ .L. .............................. Date.. --1_:_
a
Test Pit No. LAP....minutes per inch Depth of Test Pit.................... Depth to ground waterer ..... 4e-07
�X, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
04 -------- .•--. _
O Description o Soil ��«`a .. ®?.--------- �' 4.. � -..__..
U ._.... -•----------------•---------------•------------......---............------......---•-•----•-...
W
U . Nature of Repairs or Alterations—Answer whe icable.................. ........................ .......................................
••-•-------
Agreement:
-The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of TITLE 5 of the. State Sanitary Code— The undersigned further agrees not to place the system in
operation until a Certificate of Compliance ha&bissue4 by th and ofiealth.
Si . ------. .......---•-••---••-•--.......---A lication A roved B .. tPP PP Y•--••--/�------ - ---- sn,-•----• ----------------------..._...-- -•--��-"'-.�7-•
Date
Application Disapproved for the following reasons:------•--------•-•--•-------•---------------------------------•-----------------...--•-------•-••--•---.....-•--
-----------•--•---------------------------•-•----...---------..........----------.•......--•-•--•----------=-----•--•-•----------•-------•-----•-•-••-------------•-•-•-----------•---................
/���� Date
PermitNo......................................................... Issued.......................................................
Date
No _�d..�_ ...............'"".....�.......
THE COMMONWEALTH OF MASSACHUSETTS " `= "
I
BOA RD OF H EALTH
�l
Appliratiun for Disposal arks Tonstrnrtiun Errant
Application is hereby made for a Permit to Construct ( or Repair ( ) an Individual Sewage Disposal
System at
U� .. ..� ......._ ✓l,tl 1.. G'." '! ................ ............................" r/ + y •......................•-•......---•--.
' • �yA LocIon Address' �j �} r Lo
........ 1r i..!LI..�9r�# !.............•-•--•-•----......------'•............ - --.pe—V.. `= .......�'.........................................
t qnstalle;
ner Address
: Am� --------------------------- Address �}
UType of Building . Size Lot.._ _ a....Sq. feet
Dwelling—No. of Bedrooms..__, ................. Expansion Attic ( f Garbage Grinder ( )
a'4 Other—Type of Building L?�e.... No. of ersons......... .......__.. Showers —
yp g ------� p ( ) Cafeteria ( )
077�6'1 '
Otherfixtures ----------------'�---------------•-------------------------•--------------------------------------------------------•-•--- .......
W Design Flow............ .Q.................gallons per person per day. Total daily flow._::..... ii ....................gallons.
WSeptic Tank—Liquid*capacity/tO.4allons Length........ &..... Width... ....... Diameter---------------- Depth................
xDisposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft.
3 Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area............__....sq. ft.
Z Other Distribution box ("')' Dosing;tank-
"
a 01—
Percolation Test Results Performed by. _ ....---- Date...•--'2 --ram--- .........
Test Pit No. L.A®---minutes per inch Depth of Test Pit.................... Depth to ground water '...51eehi
(z, Test Pit No..2:................minutes per inch Depth of Test Pit.................... Depth'to ground water........................
O Description o Soil �-.'� AAte_ " 1�?�. f �° ... � /
. ,1 ......s0.
- ----..... ..• --•---------------------••.-•••--•--•-
W ---------------- --- ----------
U Nature of Repairs or Alterations—Answer whe cable................... .... M'
.................................... ............................
--------------
Agreement:
The undersigned agrees to install the aforedescribed Indiyidual Sewage�Dispgsal System/n accordance with
the provisions of TIT-
p S 5 of the State Sanitary Code—The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has bVt issued by the and of ealth.
sign r .-- ...............
•--.....-•-------------------- •.. S. t
Dote
Application Approved BY....... � :- .......
Date
Application Disapproved for the following reasons:........................................................................................ ....--...
---------------------------------------------------•----•---••-------------.......------.......--•-----....--•-•--•----------------------------------------------------.....---•-----••----••-----.......
Datee'(4
Permit No.......................... .. Issued.
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD HEALT
&�e
,...................OF...... � ...... :.>G,..
Tatif iratr of (Som rliFanrr
THIS IY30 CERTIF�, hat e Individual Sewage Disposal System constructed ((<or Repaired ( )
bY ._...... ._ '(-14t!d.�7......1'T`t' ._.. --------- ------
Installer ;
-;
at. jl. +r� ^J!e + t�------------------------------••----•-•-----•-••------•-------------------------------------
has been installed in accordance with the provisions of TI1 j of The State Sanitary Code as described in the
application for Dis osal`A?Vorks Construction Permit No... _ ' 7 ............. d`lted__-. __ _- ... _ `"
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A-GUARANTEE"THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
DATE....................................
...................•••-•--•....._. ........ Inspector---•---------•-•-----•--._....------------•-----..............----•------).........
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH . ....
.............. .... .........OF.............. .. ...•....................................... .�a
N .............. ?...:. FEE.... ...........
Disposal Works gait inn rrutit
Permission i hereby granted = .. ' - ..-- --......
to Constru t or Repair ) an Individ 1 . .wage Di osstem '
01
at No
St et
as shown on the application for Disposal Works Construction P it Nci `- .__.._._.. Dated... _.. .7!. .74..........
j
Board of Health
DATE..... , - •.n ........................................... .
FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS -
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THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
A -1
...........7..�...........OF.............. .......................................
N .. ..... FEE... ...........
Dispos artion "parAft
Permission ' hereby granted--. .. ....... .... ... .....
............................................ ...
to Construft or Repair t an In w divi eage Di os stem
.........................
at No%- /- ..... ......... ...7...
St eet
as shown on the application for Disposal Works Construction mi Dated.../ja7�177:.-7dr..........
-Vol
....... ..... -------------------------------
t ------Board f ;ith
DATE.-- .........................................
FORM 1255 HOBBS & WARREN, INC.. PUBLISHERS
78
No..... d .... FEE ..A.0Q.........
THE COMMONWEALTH OF MASSACHUSETTS
r�. BOARD OF � EALTH
1� ............ ..._.Town F.......Barnstable
---------------------------------------------------
Appliration for Uhipaii al jarks Tiltutrurtion JIrratit
Application is hereby made for a Permit to Construct ( ) or Repair (X) an Individual Sewage Disposal
System at:
Brooks Rd, Hyannis, Mass.
................__.-------•----..................--------------------..................--------- --...-----••----------........-----•------------------.....----------------------...............--
Location-Address or Lot No.
guSty'_s Plumbing &---Heatin�t _Inc, j naryuiin Rd„_,...Iannis, _Mass
Owner Address
a A-_&..8...cP_sLs po_oJ_.S er_Viae---------------------------------- ...128_.Ri shope...Terrac.e,...hgannia.,..Mass.
Installer Address
dType of Building Size Lot............................Sq. feet
U Dwelling—No. of Bedrooms................................ _Expansion Attic ( ) Garbage Grinder ( )
Other—T e of Building No. of persons............................ Showers — Cafeteria
Q' Other fixtures ----------------------------------
W Design Flow............................................gallons per person per day. Total daily flow............................................gallons.
WSeptic Tank—Liquid capacity............gallons Length................ Width................ Diameter................ Depth................
x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft.
Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area_...............sq. ft.
Z Other Distribution box ( ) Dosing tank ( )
Percolation%Test Results Performed by.......................................................................... Date........................................
aTest Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water........................
Gi Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water.........................
04 ---------------------------------------------------•--------------------•-------•---•--•-•--•-------.....-...-----•--------•-----....-------------- ......
Description of Soil ►5321d........................................................................................
--------------------••---------------------------------
x
U -----•••-----------•----•---•------------•--••---•--•--•-•--•-•.................................•••--.....-•---•--•---•-------------...-•-------•-------•--••••------....--•-----•--.........----•--•--
W ....................-...................................................---..__...-•------•------------•-------•---------------------------------------------------------------------•------•------•••.
UNature of Repairs or Alterations—Answer when applicable-----1.,OQQ---4.0ne--._thouseand)..._gallon.......
leach---Pit--with...extra... tone.....•--------------•-•-•••---••-•---•---------------•••----•--•----•--•-----•-•---•••-••--------•--•-----.-----------
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of L ITTIE 5 of the State Sanitary Code—The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has been issue bytlth'e �rof health.
Application Approved By'_.._.��� 0,0�6. 10Dj"j0/78
•.....
Date
Application Disapproved for the following reasons:-
-•...............•---•---•-----•--•---••-•----•--.._....-•----........................•_ --••--........
.............................. - ..........................................................
-------------••-•.-------••••-•--------------
7
Date
PermitNo......................................................... Issued........19/'>.Q178.......................
Date
s
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF 'HEALTH
r .................. ..T.owln.. ..---OF.......Barn table..----------.-----------------------..
Apphration for Uiipooal Workii Tumtrurtion Urrmit
Application is hereby made for,a Permit to Construct ( ) or Repair (X) an Individual Sewage Disposal
System at:
Brooks...�:a.a...I �raris IVlass.�. - ---------------
... ....... ----------------------------------- --
Dp�•�'' Location-Address g{M Inc., � Tf Rd, y...-Hyan $
Owner Address
w A..&---B...OgggPv v •-l g8nstaller �fee-------------------------------•-- ...128---$�-ahe a ��ressat Te e:;----Hylat� 9.9.•..chess.
a " I
Type of Building Size Lot............................Sq. feet
aDwelling—No..of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( )
p I Other—Type. of Building ............................ No. of persons............................ Showers ( : ) — Cafeteria ( )
a Other fixtures ................................•_
W Design Flow.......:....................................gallons per person per day. Total daily flow--------------------------------------------gallons.
WSeptyc Tank—Liquid capacity............gallons Length................ Width................ Diameter................ Depth................
x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft.
Seepage Pit No---------i.......... Diameter.................... Depth;below inlet.................... Total leaching area......_...........sq. ft.
Z Other Distribution box ( ) Dosing tank ( )
•-' Percolation Test Results Performed by......................-................................................... Date---------------------•--••---••-••----
,� Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................
(i Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water__.___---__•_-_•--___.-_
P4 ---------•---------------------------------------------------------------------------------•-------------....-----------------•-•--•......•--...........
0 Description of Soil...........&�.........................................................................................................................................--------
V -•••---- •••••••••-•-•••••-•---••--•-......•---••••...-•---.....••••--------•-•••-•-----••......••-••-•-•-
W •• ----------•---•----------------------------•--•---•----- •-------•-----------•----•----•- ---------••-----------------•----•------••------
U Nature of Repairs or Alterations—Answer when applicable_____]-#0GG---(-on$___thoueoartd)•- 941-1,6'n--------
laa.c h.Pit...kith---extra..st-=e..----------------------------------------------------------------------------------------•--------------------------------
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of T IT ILE 5 of the State Sanitary Code— The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has been issue by the r of health.
' to
Application Approved By s��+�shr 10 �0/7$
Date
Application Disapproved for the following reasons----------------------------•--••------------------------------------------------•---...................•-•.-----
........................
+y � ate
Permit No................. --• Issued � , 8
THE COMMONWEALTH OF MASSACHUSETTS fir.
BOARD OF HEALTH
N ...................TOWl'1;.........OF................ r13`YT 3 rc�J;lP ?! '...............-::
N (Ur#ifirFatr of Tomp nrr
If THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( } or Repaired (X )
byA.. $...�essp�v erv3rt , .}:fig..$ s +1'gr 2rCs;� � y tl i3.....g .fl26�J 1
O2-60 ---m T Mel �j,�� +
t has been mstal�led in accordance with t11e provisions of T of
�' p r The State Sanitary Code as escrib`efl tYlie4� r 'YYC
application.for Disposal Works Construction.Permit $ ._. __.___..._. dated:_..- . .........p 10� I���
THE ISSUANCE OF THIS CERTIFICATE Si&LL NOT BE CPNSTRU AS A TEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY {.
h..,,Nrae d �} '3g' "kS�`i. ,tgr fi LY a�q,>�.'.'} G,�4..<riri �.e•:§ r " -P r 't7 trDATE__. ..o
r� a air•Yr TJ .Yz
rae fTM`t-'.,.. .ter .... .,_ ., _ �"�' .•: �..._...�_,.+..s._�.�:�.' ,..'u y:.�-� .�,.w..
THE COMMONWEALTH OF MASSACHUSETTS,
BOARD OF HEALTH f'
! '
I
.....OF. } et ble... .....
FEE. 5.,gip........NO AD
/11 I
� •�.;{k ��t��w�aa1 ork� �on,��rnr#ior�;. r�n"ti#
04Permission is hereby granted..
t e,------1218-Rt-strgfft...Ter-wo----Hy n s
`'•; Ito Construct ( ) or Repair (X ) -an Individual Sewage Disposal ystem
at No.$3'0,0k.B.. EtYtY3 3`� $$$....... ... is �'8 {{���: $ i t II q �e Inc.
.t reef' �107`3 � �'
as shown on the application for Disposal Woks Construction P it No. ated..........................................
------
1 Board of Health
I
DATE....1.0./.3-0/78..:.....................;-- •. --------------
�..,,,-.... .FORM 1255 HOBBS & WARREN.' INC., PUBLISHERS}"' -
` I -�...i,,; • .'Inks,:
L.0 Cr SEWAGE PERMIT NO.
. A T ION 1 ,
VILLAGE
INSTA LLER'S NAME i ADDRESS
2
B U I-L D E R OR OWNER
DATE PERMIT ISSUED
DATE COMPLIANCE ISSUED
r
23 j
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3 �21