HomeMy WebLinkAbout0166 EBENEZER ROAD - Health (2) 166 Ca n► ��,�R D
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TOWN OF BARNSTABL.E
LOCATION Reif. SEWAGE #
VILLAGE•, OsT1r,-NI/1M'- ASSESSOR'S MAP & LOT I2 2" 0 7 —
INS.TALLER'S NAME&PHONE NO. -r,0 -y20-q= 1-105,E4 Pe SAIAI�S
SEPTIC TANK CAPACITY MOO
LEACHING FACILITY: (type) '�'-ROW 2 M i'I r) AP5(size) 1,s'2 X 2.r
NO. OF BEDROOMS
BUILDER OR OWNER 604114 Gl—c r-")r
PERMITDATE: Z�! 2 G " /, COMPLIANCE DATE: ey I
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 faciih ) Feet
Furnished by
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TOWN BARNSTABLE
LOCATION I G(P Cb1 �d SEWAGE #
VILLNGE � y� ASSESSOR'S MAP &LOT
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INSTALLER'S NAME&PHONE NO.
SEPTIC TANK CAPACITY J (�A
LEACHING FACILITY: (type) _ - �'�` (size) 600
NO.OF BEDROOMS ,
BUILDER OR OWNER �QY��L �1
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 faci 'ty) Feet
Furnished by
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