HomeMy WebLinkAbout0123 HUMMOCK LANE - Health G()Tto '7
41 KEELA WAY, COTUIT
A= 018 064
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No. 4210 1/3
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LOCATION /.3 SEWAGE #
VILLAGE D L o ASSESSOR'S MAP & LOT
INSTALLER'S NAME&PHONE NO. /"7' (-',4/7i,- ? AY00
SEPTIC TANK CAPACITY /n00 �s�//0
LEACHING FACILITY: (type) L f�A C.- 5 (size),;z 8• X OZ
NO.OF BEDROOMS
BUILDER OR OWNER �1"I l J7
PERMITDATE: ° � �' ``� %. OMPLIANCE DATE:
Separation Distance Between the:
Maximum Adjusted Groundwater Table and Bottom of Leaching Facility P, +Feet
Private Water Supply Well and Leaching Facility (If any wells exist
on site or within 200 feet of leaching facility) f Feet
Edge of Wetland and Leaching Facility(If any wetlands exist
within 300 feet of leaching facility) Feet
Furnished by
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