HomeMy WebLinkAbout1680 IYANNOUGH ROAD - Health (2) t 6 IOA Rft rJ
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//�� TOWN OF B STABLE
LOCATION M& A 18k L'c2, SEWAGE#
VILLAGE ` ASSESSOR'S MAP&PARCEL
INSTALLE NAME&PHONE NO.
SEPTIC TANK CAPACITY /
LEACHING FACILITY:(type) Z&6� (size)
NO.OF BEDROOMS
OWNER Xf'/15� 1�
PERMIT DATE: 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
= � 03
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