HomeMy WebLinkAbout0272 CRAIGVILLE BEACH ROAD - Health (2) a7A cf-d
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LOCATION SEW.kGE #
` ILLAGE 1 S D ASSESSOR'S AP&LOT
INSTALLER'S NAME&PHONE NO.
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SEPTIC TANK CAPACITY �
LEACHING FACILITY: (type) ` ` �
(size)
NO.OF BEDROOMS
BUILDER OR OWNER , 'e/
PERMITDATE: 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 lead g •acili Feet
Furnished b
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TOWN OF BARNSTABLF
LOCATION 7oZ ') 2r SEWAGE#
VILLAGEDQ' - J2OQCY ASSESSOR'S MAP&PARCEL
INSTALLER'S NAME&PHONE NO.
SEPTIC TANK CAPACITY
LEACHING FACILITY.(type) (size)
OF BEDROOMS
OWNER O
PERMIT DATE: COMPLIANCE DATE:
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
TOWN OF BARNSTABLE .31V ITS t—�
LOC.AIION SEWAGE #
VILLAGE
N S NAME&PHONE NO.
SEPTIC TANK CAPACITY F R7//� f�5P 1'C /a.v
LEACHING FACILITY: (type) (size)
NO. OF BEDROOMS
BUILDER OR OWNER
i
PERMITDATE: COMPLIANCE DATE:
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
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INSTALLER'S NAME&PH N
SEPTIC TANK CAPACITY iZZC
II' LEACHING-FACMITY: (type ! '' t j e) 31�
NO.OF BEDROOMS
BUILDER OR OWNER
PERMITDATE:` -`7 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
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LOCATION '"'/`1 //�J/r ��j'•�+ � SEWAGE #
VILLAGE ASSESSOR'S MAP& LOT
INSTALLER'S NAM) &PHONE NO. . e 0-W
SEPTIC TANK CAPACITY
LEACHING FACII =: (type) f i �-" 1(size) 1000
NO.OF BEDROOMS WC$ o"'—' � un kS 11-11 $ 1-5
UMJ;�ER OR OWNER !!�ZA
PERMITDATE: '� ' 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
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LOCATION ,� SEWAGE PEIMIT NO.
VILLAGE
INSTA LLER'S NAFAE i ADDRESS
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BUILD//ER OR OWNER
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DATE PERIMIT I S S 0 ED _ /�..
DATE COMPLIANCE ISSUED .21 —? ''
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VILLAGE Ilu" "� ��r ASSESSOR'S MAP & LOT;Z
]3�'S NAME&PHONE NO.
SEPTIC TANK CAPACITY S S` z Ceti
LEACHING FACILITY: (type) (size)
NO. OF,BEDROOMS
BUILDER OR OWNER n/� ��7 ��''�£ '1't' P/pC£ Cs0• OS
PERMItDATE: COMPLIANCE DATE:
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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