HomeMy WebLinkAbout0037 OLD STAGE ROAD - Health 4,o -1 9
N SMEA
KEEPING YOU ORGANIZED
No. 12534
2-153LOR
SUSTAINABLE
IN ITIATIR E M ONETENT710%
CmifiedAberSeuminp POST-CONSUMER
www4ffproerem rs
SR 01290
MADE IN USA
W ORGANIZEO AT SHM40M
TOWN OF
OF BARNSTABLL�E
LOCATION 7 Q /Cc EWAGE #
VILLAGE �Pv���v�(/ ASSESSOR'S MAP & LOT
P
INSTALLER'S NAME & PHONE NO.Cu,f /";P e,4c., �
SEPTIC TANK CAPACITY !�-U 0
LEACHING FACILITY:(type) /c) +Z S y A// (size)
NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATERfia i
BUILDER OR OWNER
DATE PERMIT ISSUED:
DATE COMPLIANCE ISSUED:
VARIANCE GRANTED: Yes
F-t,) � No
�� �
/io"1 'p
1
r
SSU