HomeMy WebLinkAbout0062 FOREST STREET - Health 6� Fores�F Sf., Nunn%s
�vvs /us' / -_
T
TOWN OF BARNS ABL
LOCATION /--Z✓e-<4- SEWAGE #
VILLAGE 61 . 6
2-,M Z ASSESSOR'S MAP&LOT
INSTALLER'S NAME&PHONE NO.
SEPTIC TANK CAPACITY
LEACHING FACILTTY:.(type) C-±5-5,sap 0 1 (size)
NO.OF BEDROOMS J
BUILDER OR OWNER
PERMIT DATE: COMPLIANCE DATE:
'Separation Distance Between the:
Maximum Adjusted Groundwater Table and 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 T�� (� w , R�kzer
i
M
� A
�- J
.� �
I
i
i�
l