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KEEPING YOU ORGANIZED
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No. 12134
2-153LGN
SUSTAINABLE FORESTRY MIN.RECYCLED
INITIATIVE CONTENT 10%FMI
Certified Sher sourcing POST-CONSUMER
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MADE IN USA
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TOWN OF BARNSTABLE
'LOCATION 326*faRt5S44 LAWS- SEWAGE # /'c'
VILLAGE t�S'C �I�L ASSESSOR'S MAP & LOT � �T-
INSTALLER'S NAME&PHONE NO.
SEPTIC TANK CAPACITY 10nC
LEACHING FACILITY: (type) (size) I�
NO. OF BEDROOMS
BUILDER OR OWNER
PERMITDATE: 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) 11 Feet
Edge of Wetland and Leaching Facility (If any wetlands erst..
within 300 feet of�llenaachinig/faci ' ) Feet
Furnished by
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TOWN OF BARNSTABLE
LOCATION Z 7;�n/etSm/� SEWAGE #
VILLAGE ASSESSOR'S MAP & LOTII-4-0119-0
INSTALLER'S NAME&PHONE NO.
SEPTIC TANK CAPACITY
LEACHING FACILITY: (size)
NO. OF BEDROOMS n
BUILDER OR OWNER
PERMITDATE: 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 f leaching facility) Feet
Furnished by �
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