HomeMy WebLinkAbout0160 HORSESHOE LANE - Health (2) 6e Hgo Est ska1✓ GA
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KEEPING YOU ORGANIZED
No. 12534
2-153LOR
SUSTAINABLE
FORESTRY MIN.RECYCLED
INITIATIVE CONTENT10%
Certfted Fiber Sourcing POST-CONSUMER
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SF101➢PO
MADE W USA
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LOCATION / cP G l4/4al/a L C -j SEWAGE # 47�001 ��J
VILLAGE C_ ASSESSOR'S MAP & LOT •7 1,-)-9
INSTALLER'S NAME&PHONE NO. L_c1 6-01J,-S T-"
SEPTIC TANK CAPACITY /-i-D O /
LEACHING FACIL]TY: (type) 506V1 AW4 124W, (size)/Zf
NO. OF BEDROOMS_
BUILDER R 0:jN `
PERMTTDATE: / O 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) 4t14 Feet
Edge of Wetland and Leaching Facility(If any wetlands exist
within 300 feet of leaching facility) _ ill Feet
Furnished by ljC
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41; ��
56` .
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TOWN OF BARNSTABLE '
III LOCAT RDN )'DYSQ 4Lp-e_ V-vi SEWAGE #
VILLAGE C" t.2 V i/,lLe, ASSESSOR'S MAP 6T LOT _
INSTALLER'S NAME & PHONE NO.
SEPTIC TANK CAPACITY
LEACHING FACILITY:(type) (size)
NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER__k6gjd
BUILDER OR OWNER '
DATE PERMIT ISSUED:
DATE COMPLIANCE ISSUED:
VARIANCE GRANTED: Yes No
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