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TOWN OF BARNSTABLE
LOCATION 3a wtlsef Ln. SEWAGE #
VILLAGE OS le it ASS,ESSOR'S MAP LOT
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INSTALLER'S NAME & PHONE NO.
SEPTIC TANK CAPACITY
LEACHING FACILITY:(type) (size)
NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER ��
BUILDER OR OWNER gal C. �� h-�i o (Ato
DATE PERMIT ISSUED:
DATE COMPLIANCE ISSUED:
VARIANCE GRAMTsED: Yes No
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