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S M E A D
No.2-153LY
UPC 12934
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TOWN OF BARNSTABLE
LOCATION �. �'a CsG r/I.,,. SEWAGE #
VILLAGE L= l ASSESSOR'S MAP & LOT/(�
INSTALLER'S NAME PHONE NO. �O •+ �- S �" �7 I
SEPTIC TANK CAPACITY
LEACHING FACILITY:(type) 3 0 (size)
NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER
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BUILDER OR OWNER �„ Q
DATE PERMIT ISSUED:
-41
DATE COMPLIANCE ISSUED:
VARIANCE GRANTED: Yes No
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