HomeMy WebLinkAbout0015 AUTUMN DRIVE - Health (2) _. _ _
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TOWN OF BARNSTABLE
LOCATION [ SEWAGE #
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VILLAGE_) J ASSESSOR'S MAP & LOT
INSTALLER'S NAME&PHONE NO._ in>
SEPTIC TANK CAPACITY
LEACHING FACILITY: (type) 41ZZ*44Zff TO/2_S' (size)
NO.OF BEDROOMS 3
BUILDER OR OWNER
PERMTTDATE: 'COMPLIANCE DATE:
Separation Distance Between the:
Maximum Adjusted Groundwater Table to the 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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TOWN OF BARNSTABLE
LOCATION ..I— U?r/M Q,�,I y e— SEWAGE #
VILLAGE_ 0,S%4 4/i Ile _ ASSESSOR'S MAP & LOT s�
INSTALLER'S NAME&PHONE NO. in,i9
SEPTIC TANK CAPACITY - 1,5Si d - -
i
LEACHING FACILITY: (type) 4:i/ Zn2d /D 2 (size) y 1/ rt 2_5
NO.OF BEDROOMS 3
BUILDER OR OWNER e /
PERMITDATE: - COMPLIANCE DATE:
Separation Distance Between the:
! Maximum Adjusted Groundwater Table to the 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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