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BAR NSTABLE -�8
PLAN • OF LAND IN e .
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Charles N. Savery Inc. , Surveyors e
November 169 1973
PINE RIDGE
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-� Frank S. Perkins'
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40.00-. /00.00
Wilcox
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O A K (Pei✓ate-40 rt. Fvide> STREET
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Copy of pan+of
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' LAND REGISTRATION Off/C£
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(�Q O l Scale of th;c plan G o feet to an ireh
lS'ocdcurv, Engraeer t`r Court
TOWN OF BARNSTABLE
LOCATION `Jke9 SEWAGE#
VILLAGE(2Q�1ii'Q 1 ASSESSOR'S MAP&PA�iL ®I 9"cq-5-
INSTALLER'S NAME&PHONE NO.
SEPTIC TANK CAPACITY I "cp
LEACHING FACILITY:(type) " y� X Z. (size) 1000• Ct I$) GCh
NO.OF BEDROOMS
OWNER �C�s1C_'l m
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 BYIV4w .
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