HomeMy WebLinkAbout0216 CHURCH STREET - Health (2) ICp Chu d `�j., W. Ravo .
, TOWN OF BARNSTABLE
LOCATION SEWAGE #
VILLAGE IWO, MAP & LOT /-!D— 06-61
INSTALLER'S NAME & PHONE NO. 40;W
SEPTIC TANK CAPACITY_
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LEACHING FACILITY:(type) (size)
NO. OF BEDROOMS PRIVATE WELL O PUBLIC WATER
OR OWNER e3- GCJ4G7�
DATE PERMIT ISSUED:
DATE COMPLIANCE ISSUED: 7—16—/�`
VARIANCE GRANTED: Yes No
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C�s /;�l�TOW,,N>>OF BARNST�A.'BALE
LOCATION 4162 l r '81 � SEWAGE # oCd I 0/ 4p O
VILLAGE 6S'-r J?7>A--C;,35n4-6LE, ASSESSOR'S MAP & LOT 4SL-3
INSTALLER'S NAME&PHONE NO.
SEPTIC TANK CAPACITY I G_n"r
LEACHING FACILITY: (type) �Y4� (size) l evIs
NO.OF BEDROOMS
BUILDER OR OWNER 0S, r fn,
PERMUDATE: �,r I,,�i)I�COMPLIANCE DATE: o
Separation Distance Between the:
Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet
I' "
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 of leaching facility) �� '' �' Feet
Furnished by - __
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