HomeMy WebLinkAbout0192 LINCOLN ROAD - Health (2) l 9a [,t►coln Rd•, f{�aMi P
TOWN OF BAR�NST'ABLE
LOCATION a t—9� i SEWAGE #
VILLAGE VA y Q.w1 v s .s5 ASSESSOR'S MAP & LOT -:?70
INSTALLER'S NAME&,PHONE NO. fY1 iyu- 010"Sked'A ��b��S43 —OM
SEPTIC TANK CAPACITY
LEACHING FACILITY: (type) 3 1 rehcl� LeeLJ%; y Feld (size) 18
NO. OF BEDROOMS
BUILDER OR OWNER L�bC+��
PERMIT DATE: � COMPLIANCE DATE: 'Ia4'L%
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 _
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