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0077 THOREAU DRIVE - Health (2)
r TOWN OF BARNSTABLE LOCATION_, '7 _r440eE5 A Pf,. SEWAGE# Z021 Z98 VILLAGE -_IT�Vt L&A_ :_ ASSESSOR'S MAP&PARCEL Oq 1 -F ZZ'1 INSTALLER'S NAME&PHONE NO. P-E� QT B•�cw� CAS SEPTIC TANK CAPACITY l OQ© LEACHING FACILITY:(type) S q1.CL4Arn8 S (size) J J *1C NO.OF BEDROOMS 3 OWNER 1 -t J�1 r/lSCZ-t_ eJA SSO PERMIT DATE: IB l S 1 Z.) COMPLIANCE DATE: $ 1 O Separation Distance Between the: 11 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 46D2_ _ Oe�Q_ Co . N � p r s W c vo LIN - rn a 0 c V1 • I' N