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0137 SHORT BEACH ROAD - Health (2)
�1 -7 J T SA Cyr seoc !e©ctal . .-I,e.,rv(l C)L SMEAD No.2-ML,Y UPC 12934 amoad.com • Made in USA A—rh). 9JSTAMAW FORESTRY IN ATNE Greliod ow iourtim ..r�r.erM►n..ro c TOWN OF BARNSTABLE LOCATION �rl o r+ Ac,�, (M SIDE#MrI$I� VILLAGE l�"�'eN�°�L( SSOR'JS, &P, PARCELNAME&PHONE NO , O V1 Kt, SEPTIC TANK CAPACITY 00 591 LEACHING FACILITY:(type) �GcrS X (size) NO.OF BEDROOMS q OWNER L G.CJt ru (� p PERMIT DATE: C DATE In i a 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 f ! l J r J'J l Y +• +. \'\'\ Y'hr lr Yr kr 4r Y Y Y Y Y YrYf'+f 4r f+• f44 f+JYr YlYfY/ J f J / �r \ Y \ + 4 Y Y \ Y Y f f l l f f f f ! J J J J Y 4 1 4 Y Y Y Y YrYrY J J J J J J J J / J f J f f f f ,. \ Y \ Y•Yf+'/YJYf4J1Jhr YfYJ'+fkfhfhfhf\fhf4/ Y 4 Y Y 4 '•.fYf YfYI fYf f ! f r h \ YYY \ YYY ��r`Y��hJ ���J Jfff Jf ff / J •' 36 47 33 56 • r � I TOWN OF BARNSTABLE LOCATION o M EWAGE # VILLAGE �'',�:¢r`G' r ASSESSOR'S AP LOTS—D`17 INSTALLER'S NAME & PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY:(type) ozSO S y e- 7WF- (size) NO. OF BEDROOMS PRIVATE WELL O WAT R BUILDER OR OWNER ,c e,1,0A-J DATE PERMIT ISSUED:_��_e DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No CU Cm � o P � e