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TOWN OF BARNSTABLE
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VILLAGE�� rl' I I S ASSESSOR'S MAP & LOT/O ^i
INSTALLER'S NAME PHONE NO.
SEPTIC TANK CAPACITY lei—
LEACHING FACILITY:(type) ' lodir(size)
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NO. OF BEDROOMS PRIVATE WELL O P U BLIC)WATER
BUILDER OR OWNER
DATE PERMIT ISSUED:...
DATE . COMPLIANCE ISSUED: i
VARIANCE GRANTED: Yes No ,
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