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0733 OLD POST ROAD (CT & MM) - Health
`133 o ci�� r-�r R-bc- d TOWN J/OF BARNSTABLE ��,� p l ��� _SEWAGE � )CATION LELAGE � ASSESSOR'S MAP&PARCEL INSTALLERS NAME&PHONE NO. SEPTIC TANK CAPACITYQ®�j LEACHING FACILITY:(type) • C' (size) NO. OF BEDROOMS OWNER 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 J. within 300 feet of leaching facility) Feet FURNISHED BY h 14 /3 -G A7•0 B/� •o L A TOWN OF BARNSTABLE L• CATION U o/D POST SEWAGE # ZOaY -loop r: YT�LLAGE Go i v E- - ASSESSOR'S MAP & LOT SW !l—3 USTALLER'S NAME&PHONE NO. C4-tOR-5of lawrk1 0-0 T:,Je. (Sbt s-ye. Si& SEPTIC TANK CAPACITY -(S',O o AM-[ LEACHING FACILITY: (type) IJo4 7-(size) NO.OF BEDROOMS �11c�!''�^e� �uI[��^� nkvli i'I �1611,o7 , BUILDER OR OWNER CAP-Ild£-S ;)X PERMITDATE: 11 — r O 0——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 sp • �G k ,. d} © Mo, O G�Lt04Il-o°.� L