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1456 SANTUIT-NEWTOWN ROAD - Health
I� ����� ►U� �:,� ,� �"7-) G��'.�Z—a-nS ire � L L.S TOWN OF BARNSTABLE LOCATION `TJ P2eJ~ SEWAGE# 2n(a �- VILLAGE �1 1"Yb�.�.g SSESSOR MAP&PARCEL INSTALLER'S NAME&PHONE NO. m SEPTIC TANK CAPACITY 1 LEACHING FACILITY: (type) q— A �Qe, &,-)(size) If Xo-kP K Q NO.OF BEDROOMS OWNER k'c� �l ��G PERMIT DATE: J,-A-'Jr J]t- COMPLIANCE_DATE: -'t'"'021 -1 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) IS A Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facili f Pr Feet FURNISHED BY A 3 a©ate Av 15' c� � d 3�f•s a�,5