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0184 THANKFUL LANE - Health
FA R4 tia krfiil Lane otuit= 040--039 t I� `I f TOWN OF BARNSTABLE LOCATION io►rw�{!/ SEWAGE#Q1000 ^ 307 VILLAGE ASSESSOR'S MAP&PARCELrM INSTALLER'S NAME&PHONE NO. A tOcf?ljy�3Y SEPTIC TANK CAPACITYjr� I LEACHING FACILITY:(type) s-eogja# / gdC noh (size) ZR,a I >Cy� NO.OF.BEDROOMS 3 OWNER f•�,/�--1. PERMIT DATE: Lohaoe COMPLIANCE DATE:lal Separation Distance Between the: Owe�r✓CGv�ff/ro� 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 2/9 &Dfii tv �/✓� [��Cl��' .� � I ,� a � �. - y �-f � �-�-5�0 ���s 3" 3s, S f f No. �v� Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS. application for Misposal 6pstem ConstrUttlon VErmit Application for a Permit to Construct( ) Repair(t�) Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Addresss��or Lot No./8�[b6wk b o Owner's Name,Address,and Tel.No. Assessor's Map/Farce3 �(((°v Installer's Name,Address,and Tel.No. Designer Name,Address,and Tel.No. Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building (° No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 3n gpd Design flow provided gpd Plan Date Number of sheets / Revision Date J �' Title F ,IPA,k_'4 Size of Septic Tank �/ N� Type of S.A.S. d (n [/ Description of Soil Nature of Repairs or Alterations(Answer when applicable),;G� / C mu) —bo( jg r vZ sm _-3aIlcn) 6ne e(swit yl5►-rAr Q(,� agr 016vu Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Bo ealth. Signed Date Application Approved by Date Application Disapproved by Date for the following reasons Permit No. 20,�0 36 7- Date Issued 'a� •p: 1 __ice ._ � „ �a 0? r . Fee omputer' 'x THE COMMONWEALTH OF MASSACHUSETTS Entered in c� v_Yes. PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS application for Mtsoosa �ipstPltt��0YC8tCU.LtID1� ,��Prltttt l' Application for a Permit to Construct( ) Repair(/Upgraded( ) Abandons ❑Complete System ❑Individual Components Location Address or Lot No./ f f>- g yq ,T to Ownerls.Name,�Address„and)Tel.No. p ljftll�"f)go t�301 Assessor's Ma /Parcel Installers Name,Address,and Tel.No: , De rM1 signej s Name,Address;a4keiAlo. , Type of Building: 4. Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building f t'`j/(J04 he, No.of Persons Showers( ) Cafeteria( ). a Other Fixtures Design Flow(min.required) '3 gpd Design flow provided ' Y gpd Plan Date s �21 �() () Number of sheets ti 1 � � Revision Date �h 5,�j�,;•�-�'�.� Title ,,tr Size of Septic Tank 'rXie>�,INC Type of S.A.S. -( o C( Description of Soij,,_,..d R v ` Nature of Repair's or Alterations(Answer when applicable) �ry",}l'/� l �,� �/- �, 0 all a�;a` ,�-G►r,���n�� c�rilii y(sl�r�Nl0 Date last inspeg,e& _ r� Agreement: The upde igned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance withhhe,provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance hasbeen issued by this Boardo ealth. t / t Signed �t— ( ., ' _..--- Date ��DS� 0 r Application Appfov�d by ' =�, Date Application bisa P oved by r Date for the following reasons , F Permit No. a�'+ � Date Issued ` l • d ------------------- - -- - - 0;T2HEi*0' MONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( Upgraded( ) Abandoned( )by,. A� ,{' fn, ,1 niTA r � l t'i)1 at lgq 2h k t1 e-o/-v has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. .20-"-30 A- dated 2 Installer J/T (� 11/l� n)( Designer #bedrooms _�� Approved design ow gpd The issuance of this permit shall not be construed as a guarantee that the system win function _� n as designed. t^„ Date i o Inspector ,. IN,)ti1 J -..----------- --------- No. t5,ld Fee?b1 _{ THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION- BARNSTABLE,MASSACHUSETTS Misposal *pstrm�ConBtrUction i9ermit Permission is hereby granted to Construct ) Repair( Upgrade( .) Abandon System located at 1 and as described in the'above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Y,. Title 5 and the following local provisions or special conditions. } w �• Provided:Construction must be completed within three years of the date of this permit. Date `• Y ,'-;:? ' '" ! ' Approved by Town of Barnstable Regulatory Services Richard V. Scali,Interim Director Public Health Division Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer&Designer Certification Form Date: 4 ---7: y Sewage Permit# AM-0—!,�07 Assessor's Map\Parcel O�C� As I Designer: M, Installer. Address: 6PVJT7 � Address:,.7- O(installe 4_k�, On (date a0 Z A ,3 r.�n� was issued a permit to install a septic system at based on a design drawn by (address) -- dated _ ZT , ( esigner) ertify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank- Strip out (if required) was inspected and the soils were found satisfactory. I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system) but in accordance with State & Local Regulations. Plan revision or certified as-built by designer to follow. Strip out(if required)was inspected and the soils were found satisfactory. I certify that the system referenced above was construc_;�__:`y�liance with the terms of the IAA approval letters (if applicable) ;�p��tI OF114gss�? o DAVID y . G MASON m . (InstallAig�nature�) � C' No.lass FQIS T rea w s't NI TAl1� (Design s Signature (Affix Desigri'e s Stamp Here) PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. QASepticDesigner Certification Form Rev 8-14-13.doc ;? g Commonwealth of Massachusetts Title 5 Official Inspection Form a, Subsurface Sewage Disposal System Fora-Not for Voluntary Assessments 184 Thankful Lane Property Address Diane Guidebeck . Owner Owner's Name information is required for every Cotuit MA 02635, 03'/09%1'2 page. City/Town State Zip�Code Date of Inspection Inspection.results must be submitted on this form.;Inspection forms may not be altered in any way.Please see completeness checklist at the end of the form.. Important:when A. General Information filling out forms rw on the computer, !use only the tab 1. Inspector. f keyto move your cursor-do not Michael Kellett rJ kus�erahe return Name of Inspector Aardvark,Environmental Inspections ' ,1,,, Company Name. PO box 896 _ Company Address ;G East'Dennis MA 6641 . ci. r i Cityffown. State Zip:Code• 508-385-7608" S[3742' Telephone Number License Number B. Certification certify that I have personally,inspected!the.sewage disposal system at this address,and',that the information reported below is true., accurate and complete as of'the time of the inspection.The inspection was performed based on my training and experience in the;proper function and maintenance of on site sewage disposal systems.]am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR-13.000).The system: ® Passes ❑ Conditionally Passes ❑ Fails ❑ Needs Further Evaluation by the Local Approving.Authority 03t091t:2 Inspector's Signature Date The system inspector shall"submita copy,of this inspection report tot the Approving!Authority(Board of Health or'DEP)within 30 days.of completing this inspection. if the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate:regional office of the DEP.The:original should be sent to the system owner and copies;sentto the buyer,:if<applicable,and the approving,authority. ****This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system;wilt perform-in:the future under the same or different conditions of use. A t5ins•11/10 Tille5:Official Inspection Form:Subsuifac a Disposal System•Page 1 of 17 K Commonwealth of Massachusetts Title 5 Official Inspection. Form, Subsurface Sewage Disposal System-Foirm-Not for Voluntary Assessments 184 Thankful:Lane Property Address Diane Guidebeck Owner Owner's Name information is Cotuit MA. 02635 03/09/1'2 required for every page. City/Town State Zip Code Date of:Inspection B. Certification ,(cont.} Inspection Summary:Check A,B',C:,D.or E:/always:comple.te.all of.`Section D A) System.Passes:. ® I have not found anyinformation which indicates that any'ofthe failure criteria described in 310 CMR 15303 or in 31 0 C'MR 15.304 exist.Any failure criteria not evaluated are indicated!below. Comments: B) System Conditionally Passes: ❑ One or more system components as described in the"Conditional(Pass",_section need to be replaced or repaired_The system,upon completion of the replacement or repair,as approved by the Board of'Health,will:pass. Check the box for"yes: "no"or"not determined"(Y,N, ND.),for the following,statem.ents. If"not determined,"please explain. The septic tank is metal:and'over20yearsold"orthe septictank,(whethermetalornot)isstructurally unsound,exhibits substantial infiltration or exfiltration or:tank failure is imminent.System will pass inspection if the existing:tank is replaced with a complyirigseptic tank as approved by the Board of Health. "A metal septic tank will pass:inspection if-it-is structurally sound not leaking.and if a Certificate of Compliance indicating that the tank is less than 20 years.old',is-available. ❑ Y ❑ N ❑ ND(Explain below): t5ins-11/10 Title 5 Official Inspection Form::Subsurface Sewage Disposal System-Page 2 of 17 Commonwealth of Massachusetts Title 5 Official",, Inspection dorm sj Subsurface Sewage.Disposal System Form'-Not for Voluntary Assessments s 1;84'ThankfulLane PropertyAddress Diane Guidebeck. Owner Owner's Name information is required for every Cotuit MA- 02635 .03/09/12 page. City/Town State Zip Code Date of Inspection B. Certification (cone.) B) System.Conditionally Passes.(coat:);:: ❑' Observation;of sewage backup or break out,or highs static water level.,in the distribution box due to broken or obstructed pipe(s)or due to a broken,settled'or,uneven distribution box.System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s) are:replaced � Y ❑ N El 'ND(Explain below): ❑ obstruction is removed, ❑' Y ❑; N Ell ND(Explains below): ❑ distribution box is.leveled orreplaced ❑; Y ❑ NI Eli ND(Explain below): ❑ The system;required pumping more than 4 times a year due to broken or obstructed pipe(s).The system will pass:inspection if(with approval of the Board of Health): ❑ broken;pipe(s)are replaced ❑ Y ❑ 'N . ❑ ND(Explain below): ❑ obstruction is removed: ❑ Y ❑I N, . ❑ ND(Explain below):: C) Further Evaluation is.Required by the Board,of Health: ❑ Conditions exist which require further evaluation by the:Board of Health in order to determine if the system,is failing to protect public health.,safety or the environment. 1. System will zpass lun'less'Board of'Health determines`in accordance with 310 CMR 15.30(1)(b}that the!systemis not functioning in amannerwhicht will:protect public health, safety and the environment: ❑ Cesspool or privy is within 50'feet of a surface water El Cesspool or,privy is within:50 feet;of.a bordering vegetated wetland or a salt marsh t5ins•1 M0 'Tifle:b:Official'Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 Commonwealth!of Massachusetts_ Title 5 Official Inspection Form Subsurface Sewage Disposal`System Form-Not for Voluntary Assessments 184 Thankful Lane Property Address Diane Guidebeck. Owner Owner's.Name: information is Cotuit MA 02635 03/09/1�2: required for every page. City/Town state Zip Code Date of inspection E. Ceftificatio:n (cont.) 2.. System,will fail unless the Board'of:Health(and-Public Water Supplier,if`any) determines that the system is functioning in a manner that protects the public_health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS)and the SAS is within 100 feet of a surface water,supply.or;tributary.to a surface watersupply. ❑ The;system has a septic tank:and:SAS and.the SAS is within-a Zone 1 of a public water supply. ❑ The system has a septic tank and;SAS and the SAS'is within.50 feet.of a private water supply well. ❑ The system has a septic tank:and;SAS and the:SAS is:less:than>1I00-feet;but 50 feet:or more from a,private water supply well". Method used to determine distance: "This system passes if the well water analysis., performed at a;DERcertified"laboratory,,for fecal , coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no.other failure criteria aret triggered.A copy of the analysis must be attached to this form. 3. Other: D) System Failure:Criteria,Applicable to All Systems:, You must indicate"Yes"'or"No"'to each of the.following for ally inspections: Yes No ❑ ® Backup.of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of-effluent o thel surface:ofthe ground or surface waters due to an overloaded or clogged SAS or,cesspoot ❑ ® Static Liquid level in,the>distribution box above;outlet invert due!to,an overloaded or clogged'SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6"below invert or available volume is less :than day flow t5ins-11110 Title 5:Ofrkial.lnspedion Form:Subsurface.5ewage Disposal System•Page 4 of 17 Commonwealth:of Massachusetts Title S Officials Inspection Form 1, Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 184 Thankful:Lane Property Address Diane Guidebeck. Owner Owner's Name, information is Cotuit MA 02635 03/09/42' required for every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Yes No. I Required pumping'more than 4 times in the,last:year,NOT'd'ue•to clogged or ❑' ® obstructed pipe(s)..Number oftimes pumped:: . ❑ ® Any portionof the SAS,cesspool or privy is below high ground water elevation. El ® Any;portion of cesspool orprivy'is within 1'00 feet of ta surface water supply or tributary to:a:surface watersu.pply. ❑ ® Any portion ofa cesspool or-privy is within a;Zone 1 of a publicwell.. ❑ ® Any portion of a cesspool or privy is within;50 feet of a,private=water supply well. ❑ ® Any:portion of a cesspool or rprivy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This , system passes if the well water:analysis,performed at a DEP certified laboratory,for fecal:coliforrn'bacteria indicates absent.and the:presence of ammonia nitrogen and'nitrate nitrogen is equal'to or less;than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis and chain of custody must be attached.to.this form.]; ❑ The system is a cesspool serving a facility with a design.flow of 2000gpd- 10,000gpd. Ej Z The system fails.I have determined that one or more of the above failure criteria exist as described in 310 C'MR.15.303,therefore,the system.fails.The system ownershould contact the Board`of Health to determine-whatwill be necessary to correct the failure. E) Large'Systems: To be considered a large system the system must serve a facility with a design flow of 110000 gpd to 15,000:gpd. For large systems,you must'indicate either"yes"or"no"to each of the foll.owing,.in addition to the questions in Section D. Yes No e ❑ ❑ the system is within 400 feet of a surface drinking water supply. ❑ ❑ the system is within;200 feet ofa tributary to a surface drinking water supply ❑ ❑ ther systems is located in a,nitrogen sensitive area.(in:terim;Wellhead,Protection Area. IWPA)or a,mapped,Zone+Ill of a.public water supply well; If you have answered"yes"to any question;in Section E the system is considered;a>significant threat, or answered`Yes"in Section D above the large system has failed.The owner or operator of any large :system considered a significant threat under Section E or flailed under-Section D shall upgrade the . system in accordance with.310 CMR 15.:304.The system ownershould contact the appropriate regional office of:the Department. t5ins•11/10 Title 5 Official Inspection Form_Subsurface Sew2ge Disposal!System-Page 5 of 17 Commonwealth of Massachusetts- Title 5 Official Inspection. Forms Subsurface Sewage Disposal System,Form Not for Voluntary Assessments 184 Thankful Lane Property Address Diane Guidebeck Owner Owner's Name. information i e required for every Cotuit MA 02635 03/09/12: page. CitylTown State Zip Code Date of Inspection C. Checklist Check if the following have:been;done.You:must indicate-"yes°`or°no"asto each ofthefollowing: Yes No, ® ❑ -Pumping information was Provided by the owner,occupant, or Board of Health ❑ 0 Were any of`:the system components.pumped,out in the previous two weeks? 0 ❑ Has the system received normal Wows in.the-previous.two week.period;?. ❑ ® Have large volumes of water been,introduced,to the:system recently or as part of this inspection?' ® ❑ Were as built plans of the system robtainedand examined? (If they were not available note as N/A) ® ❑ 'Was the;facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out?' ® ❑ Were all system:components,excluding;the SAS,located'on site? ® ❑ Were the septic:tank manholes uncovered,opened,and the interior of the tank ;inspected for the condition of the baffles lor tees,material of construction, dimensions, depth,of liquid,depth of sludge and depth of scum? ® ❑ Was the facility owner r(and occupants if different.from owner)provided with information on the proper maintenance of subsurface sewage disposal;systems? The size and,location of the Soil Absorption:System:(SAS)on:the site has been determined based on: Existing information.. For example.,:a; an at the Board of Health. ® ❑ Determined iin the field (if any of,the:failure criteria.related to Part C is at issue approximation of distance is:unacceptable),[310,CMR'15.302(5)];i D. System Information Residential;Flow Conditions: Number of bedrooms(design,):: 3 Number of bedrooms,(actual): 3 DESIGN flow based:onl 310 CMR.15.203(for example: 1AG gpd x#of bedrooms):: 330 t5ins-11/10 Title'5.Official Inspection Form:Subsurface'Sewage Disposal System•Page 6 of 17 Commonwealth,of Massachusetts Title 5 official Inspection. Form a Subsurface Sewage Disposal System-Form-Not for Voluntary Assessments 184 Thankful Lane Property Address Diane Guidebeck: Owner Owner's Name information is Gotuit. MA. 02635 03/09M12 required for every page. CltyTrown State Zip Code Date of;Inspection D. 'System Information Description:. Number,of current residents: 1 Does residence have a garbage grinder? ❑ Yes No Is laundry on a separate sewage system?[if yes separate inspection required]; ❑ Yes ® No Laundry system inspected? ❑ Yes ® No Seasonaluse? ❑ Yes ® No Water meter readings,if available(last:2 years.usage:(gpd)): Detail: Sump pump? ❑ Yes .E No Last date of occupancy: current Date Commemia,Ulndus$rial Flow Conditions: Type of Establishment: Design flow(based on 31,0 CMR 15.203): Gallons:per day.(gpd) Basis of design flow(seats/persons/sq ft.,etc):: Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged:to the Title_5,system?' ❑ Yes ❑ No Water meter readings,if available: t5ins•11/10 Title 5 Official Inspection.Form:.Subsurface,Sewage,Disposali System•Page 7 of 17 Commonwealth of Massachusetts Title 5 Official inspection Form, s Subsurface Sewage Dis:posalSystem Form-Not for Voluntary Assessments 184 Thankful Lane Property Address Diane Guidebeck Owner Owners Name information is Cotuit. MA.. 02635, 03/09/T2 required for every --- _. page. C5ty/Town state Zip Code Date of Inspection D, System Information (cont.) Last:date:of occupancy/use:: Date. Other(describe.below):: General'_Informatiom Pumping Records: Source of information: Was system pumped as part of the,inspection? ❑ Yes Zi No If yes,volume pumped: gallons. How was quantity pumped determined? Reason forpumping: Type of System:, ® Septic tarok, distributions box,soil,absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system(yes or no).(if yes,.attach;previous inspection records,if any) ❑ Innovative/Alternative technology.Attach a copy of the current operation and ,maintenance.contract,(to be obtained from system owner)and a copy of latest iinspectio:n of the il/A system by system operator under contract ❑ Tight:tank.,Attach a copy ofthe DEP`approval.. ❑ Other(describe): t5ins-11/10 Title 5 Official Inspeetion:Form:Subsurface Sewage Disposal System-Page 8 of 17 Commonwealth of'Massachusetts itle 5 Official; Inspection` Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments 184 Thankful Lane Property Address Diane Guidebeck. Owner Owner's Name information is required for every Cotuit: MA 02635 03/09/42 page. CityfTown state Zip Code Date of Inspection D. System :Information (coat.) Approximate age:of all components,.date.installed(if known)and:source of information:: 05/09/83 per BOH Were sewage-odors detected when arriving atthe site?. ❑ Yes ® No Building Sewer(locate on,site;plan): Depth below grade; 3.2feet Material of construction ❑cast iron [E 40 PVC . 0,other(explain): Distance from private water supply well orsuction line: feet Comments(on condition of,joints,.venfin'g,,evidence ofleakage,etc:):: Septic Tank(locate,on site;plan). Depth below grade: 2.6 feet Material of construction: ®concrete []rrretal in fiberglass polyethylene ❑ other(explain) If tank is metal,list age: -years Is age confirmed by a.Certificate:of Compliance?(attach a copy,of;certificate)! Q Yes El No Dimensions: 1!,00G gal Sludge depth: 4.. t5ins•11/10 Title:5,01ric'ial Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 Commonwealth of`Massach:usetfs Titl"e- Official Inspec ion Form Subsulftce Sewage Dis:posal:System Form Not for Voluntary Assessments 184 Thankful:Lane Property Address Diane Guidebeck. Owner Owner's.Name information is Cotuif MA 02635 03/09L1�2' required for every page. City/Town - State Zip Code Date of Inspection D. System Information 1.(cont.)' Septic Tank:(cont:): Distance from top;of sludge:to bottom t of outle tee or baffle: 27 3„ Scum thickness 5" Distance from top of scum to top,ofloutlettee:orlbaffle Distance from bottom.of scum to bottom of`outlet tee or baffle 16n. How were dimensions determined?' measured! Comments,(on pumping,recommendations,inlet and outlet tee or baffle condition,structural integrity, liquid levels:as related to outlet invert.,evidence of leakage-,-etc..).: The tank was sound and tight.with tees-in,place and liquid at outlet invert Grease TraP(locate on ste Ian)Depth below grade: feet Material of construction;: Elconcrete El`metal fiberglass polyethylene ❑!other(explain): Dimensions: Scum thickness Distance from top,of scum.toa top;of outlet tee,or,baffle Distance from bottom of scum to bottom of outleffee or baffle: ,Date of lastpumping: Date t5ins-11/10 'Tide 5'Official Inspection Form:Subsurface Sewage Disposal System-Page 10 of 17 Commonwealth of Massachusetts Title 5 Off--.Icial Inspections Forte} Subsurface Sewage'Disposal System Form Not for Voluntary Assessments 184 Thankful Lane Property Address Diane Guidebeck. Owner Owner's-Name information is required for every Cotuit MA. 02635 03109/12 page. City/Town State ZipCode Date of inspection D. 'System Information (coat.) Comments(on pumping,recommen.dations,'inlet:and outlet.tee or baffle.condition.,,structural.integrity, liquid levels as related,to outlet invert,evidence:of leakage,etc;): Tight or Holding:Tank(tank must be pumped:at time;of inspection)(locate;on site:plan). Depth below grade: Material of construction: ❑ concrete ❑metal: ❑ fiberglass ❑polyethylene ❑other(explain): Dimensions: Capacity: . ;gallons Design Flow: gallons pecday Alarm present: ❑ Yes. ❑. No; Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: ate Comments(condition.of alarm and:ftoat:switches,etc.). Attach copy of currentpumping,contract:(required). Is:copy attached? ❑; Yes ❑ No t5ins•11/10 Title 5.0fficial Inspection.Fbnn:Subsurtace Sewage DsposaPsystem•Page 11 of 17 Commonwealth:of Massachusetts Tithe:_ 5 4i'cial' Inspection Form Subsurface Sewage:Disposal System form-:Not#or Voluntary Assessments 184 Thankful Lane Property.Address Diane Guidebeck: Owner Owner's Name information is required for every Cotuit MA 02635 03/09/12: page. City[Town State Zip Code Date of Inspection D. System Information (cont.) Distribution,Box:(if,present:must:be.opened),(locate:on.site:plan) Depthr of liquid;level above outlet.invert even: Comments{note if box is level and distribution to outlets equal, any evidence of solids carryover,any evidence of leakage into or out ofbox,etc..): The box was level and tight with no sign of carryover. Pump Chamber(locate:on site:plan): Pumps in working order: ❑, Yes ❑ No Alarms in working order. ❑ Yes ❑ No Comments(note conditionWpump chamber,.condition of pumps and appurtenances,etc.): Soil Absorption.System,(SAS).(locate-,on:,site plan,,excavation not required),:: If SAS not located,explain:why:. t5ins•11/10 Title,5.Official.Inspection.Fonn:.SubsuAacetSewage Disposal System-Page 12 of 17 Commonwealth,of Massachusetts Title 5 Official Inspection Fora s 'Subsurface Sewage Disposal System°.Fo.rm-Not for Voluntary Assessments 184 Thankful Lane Property Address Diane Guidebeck. Owner Owner's Name information is required for every Cotuit MA 02635, 03/09112. page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Type::- 1. Z leaching pits, number: ❑ leachingchambers number: ❑ leaching galleries number. ❑ teaching trenches number,length:. ❑ leaching fields number,.dimensions:: ❑ overflow cesspool number: ❑ innovative/altemative system Type/name of technology:: Comments(note condition of soil,signs of hydraulic failure,level'of ponding,.damp soil, condition of vegetation,etc.): This system has a 6'x6',precast,pit surrounded by 2'of stone_There.was 2.5 feet between the stain line and theinlet invert. Cesspools (cesspool must;be pumped.as part of inspection) (locate on site plan): Number and configuration Depth—top of liquid to tihlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool! Materials of construction Indication of gro.undwa.terirtflow ❑ Yes ❑ No t5ins-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 13 of 17 Commonwealth of Massachusetts Title 5 Off�ctal Inspection Form s -Subsurface Sewage Disposal System Foffn Not for Voluntary Assessments 184 Thankful Lane Property Address Diane Guidebeck: Owner Owner's.Name information is required for every Cotuit MA' 02635< 03/09/1'2' page. City/Town State Zip Code Date of:Inspection D. System Information (cont.) Comments(note condition ofsoil,,signs=ofihydraulic failure,level,of:ponding,condition,of vegetation, etc.): Privy(locate on site plan):: Materials of construction: Dimensions . Depth of solids Comments(note condition,of soil,signs:of'h,ydraulic failure,level.of ponding.,,condition,of vegetation, etc.): t5ins•11110 Me 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 14 of 17 1 Commonwealth of.Massachusetts Title 5 Official inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 184'Thankful Lane Property Address Diane Guidebeck Owner Owner's Name information is " Cotuit MA 02635 03109112 required for every State Zip Code Date of Inspection page. Crtyrrown D. System;Information (cont.) Sketch Of Sewage Disposal System:Provide a view.of the sewage disposal system,including ties to at least two permanent reference landmarks or benchmarks_Locate:all wells within 100 feet Locate where public water supply enters the budding.Check one of the boxes below. ® hand-sketch in the area below ❑ drawing attached separately rb Vl� a ya Tft&OMcW tnspecnon Form:Subsurface Sewage Disposal System•Page 15 at 17 t5ins•I I110 Commonwealth,of Massachusetts lugTitle 5 Official Inspection Form 'Subsurface Sewage',Disposal System Form Not for Voluntary Assessments 184 Thankful,Lane Property Address Diane Guidebeck Owner Owner's Name information is Cotuif MA U2635', 03/0911'2':: required for every page_ City/Town. State Zip Code Date of iInspection D.. System Information (cont.) Site Exam: ® Check Slope ❑ Surface water ® Check cellar ❑ Shallow well's Estimated depth to,high ground',water:. 20".0 feet. Please indicate all methods used to determine the high groundwater elevation: ❑ Obtained from system design+plans on record If checked,dateof*designplan reviewed:: Date ❑ Obs,ervedi site(abutting;property/observation:hole;within 150 feetof SAS), ❑ Checked with local!Board of'Health-,explain: ❑ Checked with focal excavators,,installers.-(attach docurnentation)� ® Accessed USGS database,-explain:: You must describe howyou established,the high;ground water elevation: USGS maps show an elevation of over 20 04eet. • Before;filing:this°Inspection Report,please see Report Completeness Checklist on next page. t5ins•11/10 'Tide5Official Inspection.Form:Subsurface Sewage Disposal System•Page 16 of 17 Commonwealth of Massachusetts Title 5 fficial Inspection Form Subsurface.Sewage Disposals System Form; Notfor Voluntary Assessments, 1184 Thankful Lane Property Address. Diane Guidebeck Owner Owner's+Name information is required for every Cotuit MA 02635 03/09/12 page. Cftyrrown: state Zip.Code Date ofj Pnspection. E. Report.Completeness Checklist ® Inspection Summary:A, 8,C,D,or E checked ® Inspection Summary D(System Failure Criteria Applicable to All Systems)completed ® System Information—Estimated depth:to high groundwater ® Sketch of Sewage Disposal System,either drawn on+page 15 or attached:in separate file t5ins•11/10 Trtte'5 Official Inspection Form:Subsurface Sewage;Disposal System-Page 17 of 17 McKean, Thomas From: McKean, Thomas Sent: Friday, September09, 2011 11:14 AM To: Dabkowski, Cindy Subject: RE: Amnesty Program Applicants Questionnaire's Hi Cindy, 1. 82 Furlong Way, Cotuit-APPROVED. 2. 712 Oak Street, West Barnstable- DENIED, too many bedrooms for the septic system and size of lot, on well water 3. 854 Phinney's Lane, Centerville- Under further review, housing inspector to schedule an interior inspection, first floor "office" room to be viewed 4. 184 Thankful Lane, Cotuit-APPROVED for three bedrooms maximum. 5. 61 Tellegen Trail, Centerville-APPROVED for four bedrooms maximum. However, there is a special condition: the first floor"study" room doorway entrance shall be five feet wide minimum without a door there in between the study and the bedroom, as shown on the submitted drawing. -----Original Message----- From: Dabkowski,Cindy Sent: Wednesday,September 07,2011 1:55 PM To: McKean,Thomas Subject: Amnesty Program Applicants Questionnaire's Hello Mr. McKean Can you give me a status update for the following sites . 1. 82 Furlong Way Cotuit 2.712 Oak St W. Barnstable 3. 854 Phinney's Lane Centerville 4. 184 Thankful Lane Cotuit 5. 61 Tellegen Trail Centerville Thank you Cindy Dabkowski 1 Y Fax Send Report SEP-09-201109:34 FRI Fax Number 15087906304 Name BARNST HEALTH Name/Number GMD / 915088624782 , Page 1 Start Time SEP-09-2011 09:34.FRI Elapsed Time 0012011 Mode STD ECM Results [O.K] Cown of Barnstable . health Inspector � Hours +� Regulatory.Services 8:30e 9 0 54 Thomas F.Geller,Director 3.30. 4:30 UARNSTAEM Public Health Division ate. bw p�e� Thomas McKean,Director 200 Main Street,Hyannis;MA 02601 Office: 508-862-4644 pas: 508-790-6304 AMNESTY PROGRAM APPLICANT-SEPTIC QUESTIONNAIRE Datc:August 11,2011 1. General Information: Size ol'Property:,0.49 acre Address:184 Thankful Lane Cutuil,MA 02635 Map 040- Parcel 039 Name:Diane Guidebook Phone#i 508-776-1644 2a. How many hedrooms exist at,your property now?2 bedrooms 2b:Are you planning to add any bedrooms?One bedroom in basement fur apartment If yes,how many? l 2c. How many bedrooms total are proposed at this property(including the amnesty unit)?2 2d.Please include a copy of the floor plans for the entire property. Neatly use a straight-edge. Show all casting rooms in the home and the proposed amnesty apartment. Provide width measurements of any open doorways. Please label each room clearly. 3. Is the dwelling connected to public sewcr7 'NO Tf the dwelling is connected to'public sewer,slip yuestimis 114 0truuglt#9 below. —. - 4- Location ofdwelliug is INSIDE ' a Saltwater 13stuary Protection Zone? 5 Loe*pn ul-dwelling is OUTSTr?F. a Tome of Contribution to public supply wells? . At' 6.1s thq.d:welliti2 connected to PUBLIC W.47ER? Yes 7- Ts a disposal works construction permit on file? 4 YES or NO 8. if ye`c flow erany bedrooms were approved according to this permit?- Bcdiooms. - - Q. Wcr�-a�rty boding perniits,obtained for cunsirunlion of additional bedrooms? YES -or, NO 10- is thcrc an=ginceted septic system plan on file at the Health Division? YES or NO 11. Has the septic system been inspected by a DLP certified inspector Within the last two years? YES or NO F,USP.QNI.Y - -. The Public Health Division has no objecli Lo bedrooms at this property. ., Special Conditions: Sigtte Date: % town of Barnstable Health Inspector optHe tp� Regulatory Services Office Hours �y ,p 8:30—9:30 �.� Thomas F.Geiler,Director 3:30—4:30 BARNSMBLE. * Public Health Division 9 MASS. g 1639. Aim Thomas McKean,Director �ArFD MA'S 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 AMNESTY PROGRAM APPLICANT — SEPTIC.QUESTIONNAIRE Date:August 11,2011 1. General Information: Size of Property: 0.49 acre Address: 184 Thankful Lane Cotuit,MA 02635 Map 040- Parcel 039 Name: Diane Guidebeck Phone#: 508-776-1644 2a. How many bedrooms exist at your property now?2 bedrooms 2b. Are you planning to add any bedrooms?One bedroom.in basement for apartment If yes,how many? 1 2c. How many bedrooms total are proposed at this property(including the amnesty unit)?2 2d.Please include a copy of the floor plans for the entire property. Neatly use a straight-edge. Show all existing rooms in the home and the proposed amnesty apartment. Provide width measurements.of any open doorways. Please label each room clearly. 3. Is the dwelling connected to public sewer? NO If the dwelling is connected to public sewer,skip questions#4 through#9 below. 4. Location of dwelling is INSIDE a Saltwater Estuary Protection Zone? 5 . Locn ofdwelling is OUTSIDE a Zone of Contribution to public supply wells? AP 6. Is thePdwellin connected to PUBLIC WATER? Yes cc� 7. Is a d'sposall works construction permit on file? YES or NO t r a 8. If ye�5how many bedrooms'were approved according to this permit? Bedrooms. 9. Wer any btri-lding permit obtained for construction of additional bedrooms? YES or NO c- 10. Is there an engineered septic system plan on file at the Health Division? YES or NO 11. Has the septic system been inspected by a DEP certified inspector within the last two years? YES or NO ----------------=-------------------------------------------------------------------------------------------------- E USE ONLY J The Public Health Division has no objectio to bedrooms at this property. Special Conditions: Signe Date: FROM AZi,E� PROGRAPHICS FAX NO. :5084200130 Aug. 08 20 03:33PM P1/1 �y !" �\y'► Eli ....... . n['��/I 1• /j\R�� l r _�`..y •i +n , V ji ail .... . . .. . �.,� -._ .... ... i ! NA, �b {B �Yt{ PPPt1451_: ......._. ... _ �... -'Y^-• EI•. ._ _.. __ ,,,.�' .,..... '..'. s -NYl: . { I J i r,4 r ``Jr IS(i i li I� . E s;� 4 , 12 r 1 ��ll5' / 1 �` j .... .. ....�. ..... ._ .. Ir ,M ,i ... , 41 spi , r�• �qqqqqq S I , pypy e w • 4f4�,i6 ik i_r _ -._.. I r l rktj`�c `� 1+i g ',I . i}aka'! i71 F i bppi '�� aq�cyM1 -%i AsBuilt - Page 1 of 1 40f 73 •y s 'J Sewage Permit No. Location: Village: C.�r•�t�J�,j Installer's Name & Address 'West B.-i-nstai:,:t• Builder's Name & Address 4vy mod Date Permit Issued Date Compliance IssuedO ` y . http://issgl2/intranet/propdata/prebuilt.aspx?mappar=040039&seq=1 7/25/2011 7 - �Gy / Sewage Permit No. Location: Village: J N A p T �+ Installers Name & Address West Qarnstau L, ima s! y - 8 Builder's Name & Address c7Za 14-7 e111n 04,-, 5 Date Permit Issued Date Compliance Issued �71 ,°_ i %/ �_, 't � \ �� j / `�i. �� �, �• - � \ \ � \ � . � ' THE COMMONWEALTH orMAssAc*uscrTe - � . . �^ ������ ���� ���� HEALTH ~~~~,"" "�~ �~" " "�~" ^�~ " " " ��F --------___- ......................---' . �~°° �� lira�o�� �� ��paa�� Works Tvavua[tion Frrulit ` Application is hereby made for a Permit,to Construct (��\ or Benu� ( ) an Individual Sewage osal - System at: .............ljl.�.......... n . .....4...... ...........................................0 ........................................ . ....rr, O"r ddl fe�ss, Dwelling—No. of Bedroo r P4 _. q vy,_- - � Seepage Pit Nu—_...—_. .................... Depth below Total 6t. Z (}tbcc Distribution box ( ) Dosing tank ( ) ~~ Percolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. ]................minutes per inch Depth of Test Pit.................... Depth tn ground water-.--.---_.. Test Pit No. 2................minutes per inch Depth. of Test Pit.--.------' Depth to croou6 water.................... ` ............................................. ............................................................................................................... ` 0 ' Description _ - - ---'............................................................ ` ` .-.-_------.-'�---''-._.-.----_-----.---__--__.-------'_--_---_--_---''-----'_'---_ �� Nature of �orAlterations--Answer when applicable----...--._-'--.------_------.------.------_ . � -._---.-.---'-.-_-'--___-_'-_--_-__-______'__-'_------_-----._-----'-_---'--_______'- Agrccoeot: The undersigned agrees to install the uforedescribed Individual Sewage Disposal System in accordance with the provisions of TI ILT,1E, 5 of the State Sanitary Code�'the undersigned further agrees not to place the system in operation until a Certificate of Compliance has been * ed by the ^' Application` � - Approved B'.-. .--.-._-________--_--___---_ .... . ...,~-_-'-........... ~~` Application Disapproved p,r th ollowing reasons:................................................................................................................ -'----'---------------------'-----------'------------'-----'----- ' Date Permit rio. ° •. FE$.. ........................ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........................................OF................................_I.....--------------..........I......................... Aliptira#inn for M.5pniial Work.5 Tnnitrnrtinn ramit e p Application is hereby made for a Permitr to Construct (V) or Repair ( ) an Individual Sewage Disposal Systemat• /-.........1..�y ... i...........Y..L....... ............................................. .�.................. . ..... cation-Addr ss * or Ut No. : 1` - ..... ................. .....1, .._._. -------.. ! O r r d ess a .......... Q.s'�1/ ................. 4.................... ................ ...... e........ Inst ller Address Q Type of Building Size Lot........................... . eet V Dwelling—No. of Bedrooms.............E.............. _Expansion Attic (�V Garbage Gri der U Other—Type T e of Building — Cafete P-1 YP g -- -fit-e=a •--------. No. of ersons.....----•------------------ Showers �. Q' Other fixtures ...... .............................................................. Design Flow....... 1.:... ...................gallons per person per day. Total daily flow..... _ _.••_.__...._._.........gallons. ' P4 Septic Tank—Liquid capacity/tom..gallons Length................ Width:................. Diameter................ Depth................ Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No..................... Diameter.................... Depth below inlet......:............. Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date........................................ aTest Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................ t14 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water----_____-_.-_----_-_--. 1:4 1 •-•---•----•-•--•-•--•-••--••---•••--•-•-•-••-••.............•----•.............------------................................................................. 0 Description of Soil........................................................................................................................................................................ x W -•--•••••••----------------•---------------••----•--•-•••-----•--••---••••-•----•---•-•••••••••••-••-------------------------------•-•-•-••-••--••-••----•-•-•----••••-•-•••••............--••--........ UNature of Repairs or Alterations—Answer when applicable............................................................................................... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of IL Lip 5 of the State Sanitary Code=The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been ' ed by the b f h th. ... ............. ................ ...... .......... T. r Application Approved By;Zthlfollowing ` f" `' ----------------- --------- Date Application Disapproved reasons-------------------------------------•----------------------...---------------------------------•••............- --•••••••---•••••........••-••••-------•-•••-•••-•••--••---•••-•--••-••••----•..................••-••••---•••••......••••-•-------•------•-••-•-•-----------------•----------------•------......-••---- Date PermitNo......................................................... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........................................OF.................................................................................... w1wrtifiratr of Tom;lIiFanrr a I x CERTIFY, That the Individual Sewage Disposal System constructed ) or Repaired------------------------------------------------------------- ( ) by&/ .................................................. Installer at ---.. ..--• $ .... - ----------------------------�--t---- ---------------------- has.been installed in accordance/onstfuction .the provisions of TI1 LY; 5 of The State Sanitary Codeas erribed in the application for Disposal Works Permit No... 3i .;2_._ ............ dated:.:f/ ._............................... THE IS DANCE OF THIS CERTIFICATE SMALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEIooI LL/'/FUNCTION SATISFACTORY. DATE.�. ?of d y Inspector... ----------------------------------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .r ....................O F.........................................':.......................................... No. ... FEE. .................... Permissioni �eby granted --- .--'.................................................................................................................... to Constru t r R p ( n Indi ual Sewage Disposal System •- Street at "" as shown on the application for Disposal W ks Construction Permit No......... __ e !. ...........:. ...............................................•- --•--............................................_ oard fHealth DATE................................................................................ FORM 1255 HOBBS & WARREN, INC.. PUBLISHERS i i • I vl 0 N � � \ 10' DIAf� AG¢dVl� ��•i 6� i'� "DEPT44 TEST P! too 06AL.C0kX 1 i' SEPTI L- TP+N W- 0' f V4. :' d, PeoP�s�L ; a0 SOUSE I ! y r !Y f EOeLD PE Ri> Co-emu r T" 2 i !ti JJ toc f, XV ti it. , C?4 ST. 14' oap CcFT• DAM. fJ,h 0• 1 Cow, g a o o Co# c. LgAGN w( Prat-• O 0-Q P A aAA , a o n ZIT• AA S A &A BOT. Vie? -+'►V t . Lo AAA Dl o P, ; 3 S DuooMs x RO dtPV, - 33CtG.Pp AcNtt�t�� d` ` A i/.� y '` s ��.' .C-�r e ►� brs .00 o GALL-SEFTccT j l C D,f u - a.t i O•_ { i 1 1. { V. A "' ��'..,/"'{' SAO� . �STAG � � T .7C PD ' .. . , • - �'caT� . � t S:P��fl�.; S�(ST�t�[•; U�s tr.�+�1�tD -r-h� ' . . 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'�s..-•.•;A�^eo,•.fi:a..__r- "'we�IfO{deb.T•a.+irM•fx-o.se=". .-�'.s•'1•1 .--.c_-. .'�v.L'b'�Jc�s.�_�-.x��•�.Sn:^^-_ - •c- ' Thi inStai,c*;i()r1 SFri!!! E__^.m1ii<<"'Att, '- ate Enl'iralTtit"��lta! Town 'G/C' th.. �/Al.I.TT!�: A ID vg �' ;f.. T� r I RE• ♦ �y 7 6 4 ✓`. ' Se(7t: $tE n� 75 _)*JS�Cf^�1!r :.f I !i t i - c s ari steal!not tis ins?a;:•E.i ��nc!.ri i.�°:-lsecf town irls_a'l�[ approval ind t=i i?rA;!d8tior. pttrnilt front the applicalbi:'. i.0vjn- �� .� . -. , � _. +�i lr3[ to installation,t `.: '?+1�_ 5 .:)s# 'jrif>;the iera .?p! !i;ire ;l :ill('!ts, se'we'y11F w t k , 1 ;;od existing septic noc�i en— i cor. t:;i��: �: InSCr1�3ii01^. — •.�� ! Ali gravity sewer pipii<-rg v! be,4sl?::': schedule 40 PVC at 1;S' .?:`,C ',"e first G feet Ut)c o t'!e distribution box sll li b2 It-vel. t,-!I ;;;ping connections ici i e 0 i==r_ n �,D .'cam i y� - :,:i5 sPpri;_design ufar, i �:;:r u :t . _�rE for;�rnperty lint .ter for any other p '(pose ot:iet thz-1t�24;3-(iU; Y.`ie�� 5=�;iu�Sy5teftl1flrtdill8ti011. ii Title ti rORl�a:+�nTt-3��' f :�•'�y T i ?<.�1{SnC'CIfICSL10m. �� i i /G� , g ��o `h'ki►�g shall be p t3!lif itE_'� I'+ .:[• :G""rlC)rit'iit5[tfll£:�:. �i±ti�;` 1 . :iI F! i,20 loaded, L +�, �lQ! ;-J __._ - ._-L__..___- .-.._ .____.._. existing icy s 4,5'.- t3 T e' ! i .A { I ✓I, , 1 I "ie Sting leaching c i i' :�e p n n d and fi to ! >r'!tl`;�o,.arial iner Ti't:e V }X �� i a0andopment procedu;�_:: !23s;Fl i:r_ ::}ICI cesspool(s)and C^,0.4!nir'ated 5=)!i5 within the ::posed SAS shall be .,::r:..:!..:._ :e0aced with cseap. saws :Jet `iVe . -!tifications. /� „ (� e ?; 'Ic'f*0tic minoonents are . <.',i-.' .i a:i " water service Tine. eik,vi ii:-,e-ti _'t CSi`_; i1�a water Nne yil: 7 �# !i'' SICev£d ldiIh aR ai]?Cr;:±::'a i'i Ci.!e•,'. chedtile 40 PVC will:o,nd; �;, !ill'[: The water SetV:Ci ,�i,`� she serjt._ fn? :_ ~;�.. ;.li the sieeve being �i3,. ��t` _i�i?s .- "� ' the line. 2O�►f�J 1 ?, :�, garbage grinder P.xl�:t:==.1 :'i( i>: P,It iS t0 =r?Mov d i> _fly'Sep'c: 1Ster:'1 is not r _ iKne�V SM to acc r)riln er' :_. - ?r•r:�ar + T i i.r: insta#Qr 1 . c+ �: -t! T ]t` , rV�e �JD i - I 5 tl's1.i;P aVa ion arotsr: d: ;, V `Z.7 - 1! --- `7' ,_ ��v ` �i.i.iectinsthestrrjcTL:.rt� :r9. .., .. -, ttrv.tore � r,� ? _ ��pp�• r ' ' ° 5 vi�nn t. :_ i#1.: !e_n 1-E�CesS J'thte sew t ( pia only represents 1': ;A; Psferr iaS11Q . ! eELigTlflP V It it ,'c,t�krerner ts. �`( ��#a i # --.• ��r �''?' property owner `.:!lt i r::li.' v�itnc;ig;, c.itE'ria t0 apjJrow,ii':Lato #?ltr +t'° of bedrvarri5 ar.r' k}� f� 4 iKn flow. Inst211atiG: 'li `i;._ , i;ii� -tern as proposed an re f' Ft: . '.riment for tilt`'de!.i�:;r '� &:I l]e t3(?Q;31f'li:3l3Prf;�iri:�ii't`li'. ,. :fury �YIt':.'.1'!c7 I7V T�Re i,7rf)�,li:•�1�•.)�+s.'?7$r t? �;i`:nl:U�. . (1/ f ! l � r 4 ]� ' T.,le validityref this plan"i 'il: f'xpjr"c,-::r'Tl`+ the expiration of 0t,?Lt.,:''iri irt`si:,'[!,tT.t(In permit 1rsUe.:. iC.I \ / O O v,t plan or the valid il f l i:'til!.Pi<Qtif'no the 'XT)ii lt•f±, �j t iti�te of�.urnt?i:.i r "1 -�. `` '� } -{•,. ed for ! .i W" 'I h", a1 DAVID13 155 9c� o SON c y NO.1D66 -I 2 - - Cm T•y52, # - �. V :•' 'tNl M C �j 1 O Ir` a// '1� �C7 fite.y'a�a-:.+a.:•-•'As vT-=fCY:Z3-]wa•e_'°is�wf.++.+�ot•:st'mr.^ae�e.x•±r.n.-_ ,r,�.�.n pvu+�,-�sr,•-g{ s 40 :1) %49a 0 , -qz) ---'10 P,�4 K ro L_ 0qLA-4E Gc�JU� FtV _kA Lfu PA —�--�T•.wenu:srwssS�e.:x.•,>u-�s,�aar�v;ca:s,�w�sr�ywwa�sr.oAs�wra--�at•xs+ - _ -.-,_- -- ..... �-.�•�.`• -. _.. ._ ... _ ..). .cad:' �q�M�;°Kiy.-c�wY•^,�={-,.Y::�....