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HomeMy WebLinkAbout0273 ELLIOTT ROAD - Health (2) © *7y SMEAD No.2-153LY UPC 12934 smead.com • Mach In USA SUSTAIW191.E faRESTitY WMATWE prWl-MerSo-mi" I I r TOWN OF BARNSTABLE 6: SEWAGE # MAP & LOTS, O y .PSTALLER'S NAME&PRONE NO. SEPTIC TANK r'APACITY <5:&\ 3 LEACHING FACILITY: (type) C���c-�..�, �`�' (size) \Ql� NO. OF BEDROOMS BUILDER,OR OWNER PER.mrrDATE: dal '7Y 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 ���'� C�� „��s�z'�-.�'��`✓� I � J (op 3 O � !`3 jl-L _ EC , LOCATION SEWAGE PERMIT 010• �",C1 ioD -io ML LAG E 6 �7X I N S T A LLER'S NAME ADDRESS 11UILDEIII OR OWNER DA T E P ERMIT ISSItE D DA-TE COMPLIANCE_ ISSUED -- '1 Q - /7S� - as