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UPC 12034 a
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NASTING6,MN
~ ` TONWGN OF BARNyS�TAB�,LtE
LOCATION 35^0 SEWAGE # Rt
A- 1Ss -�.032. 002
VILLAGE �/, .oL'i� � 'nLt ASSESSOR'S MAP & LOT
INSTALLER'S NAME PHONE NO. Weer-E`t C.p,,p-y- 111 -
I� SEPTIC TANK CAPACITY l l OOO
LEACHING FACILITYAtype) IN— (size)
NO. OF BEDROOMS- PRIVATE WELL O PUBLIC WATER
BUILDER OR WNEREtr3 ��n � � C
DATE PERMIT ISSUED:
DATE COMPLIANCE ISSUED: �1.",I��.
VARIANCE GRANTED: Yes No /�
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