HomeMy WebLinkAbout0457 OLD STAGE ROAD - Health (2) �G7 old 6-1-ex� (�o�
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L15-7 TOWN OF BARNSTABLE
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LOCATION T OLD 57aOe- R D SEWAGE# W21
VILLAGE 6-t"T CU'j�l� ASSESSOR'S MAP&PARCEL /QQ" 06
INSTALLER'S NAME&PHONE NO.� ji �5 �� v.Z-Octe
SEPTIC TANK CAPACITY /�Q�ea) •Io F�7"2S lreans enJ
LEACHING FACILITY: (type) C (size) a( 33�'+
3�
NO.OF BEDROOMS q D'l Deg l
OWNER L.I Q C A, K&6oLKA
PERMIT DATE: COMPLIANCE DATE: q
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
led
/ 0 & 3
31 1
3 O S 30 �
33 S�
,� .� 37 `� S� �