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TOWN OF BARNSTABLE�
LOCATION SEWAGE #
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VII.LAGE�!/ ASSESSOR'S MAP & LOT -6G Td-v
INSTALLER'S NAME & PHONE NO. �_ c�✓'
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SEPTIC TANK CAPACITY o
LEACHING FACILITY:(type) (size)
NO. OF BEDROOMS_ __PRIVATE WELL OR PUBLIC WATER
BUILDER OR OWNER
DATE PERMIT ISSUED:
DATE COMPLIANCE ISSUED_
VARIANCE GRANTED: Yes No c��
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