HomeMy WebLinkAbout0004 CENTERBROOK LANE - HealthFy brook _
1 � 2 ��50
S M E A
No.2-153LY
UPC 12934
amead.com • Made in USA
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Carded R6ar Sourcing
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TOWN OF BARNI�E /N�- 1
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VILLAGE
�/J%�,���/Ur � ASSESSOR'S MAP.&PARCEL T�� •- �,�
INSTALLER'S NAME&PHONE NO. � _
SEPTIC TANK CAPACITY / b' "
LEACHING FACILITY:(type) a -S G _a ' - (size) 1,9
NO.OF BEDROOMS
OWNER
PERMIT DATE: li e���1c'y0 COMPLIANCE DATE: b 4 o
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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