HomeMy WebLinkAbout0175 HOLLY POINT ROAD - Health 179 Ndjly POch*t rj
2,3-2- — 017
/// S M S A D
KEEPING YOU ORGANIZED
No. 12534
2-153LOR
FORESTRY MIN.RECYCLED
HTWIVE CONTENT10%W
CaMadFiberSoflnp POST-CONSUMER
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MADEINUSA
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fTOn OF BARNSTABLE
LOCATION �l
VILLAGE ( ca /+(, ASSESSOR'S MAP & LOT Z—of 7
INSTALLER'S NAME&PHONE NO.
SEPTIC TANK CAPACITY
LEACHING FACILITY: (type) (size)
NO.OF BEDROOMS a
BUILDER OR OWNER .bm( � 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-Faei-ity-(If-an--wetlands-exist
within 300 feet-.of-leaching-,facility) I Feet
Furnished by
4
Pam .
Ho
3-7
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