HomeMy WebLinkAbout0521 MAIN ST./RTE 6A(W.BARN.) - Health (2) f /y /2/�^/'7 _
r /
,�
. �Ikls
d
i
I
I
i
TOWN OF BARNSTABLE
LOCATION Ste/ ,Sjrr ,('j �i� .D.�tz�' SEWAGE#
VILLAGE ASSESSOR'S MAP&PARCEL
INSTALLERS NAME&PHONE NO.
SEPTIC TANK CAPACITY
LEACHING FACILITY:(type) -ew'Cir (size) 3,<"x "-T X�
NO.OF BEDROOMS ::%f-
OWNER
PERMIT DATE: COMPLIANCE DATE: " oZ a
Separation Distance Between the:
Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility y Feet
Private Water Supply Well and Leaching Facility(If any wells exist ,,
on site or within 200 feet of leaching facility) J S—o Feet
Edge of Wetland and Leaching Facility(If any wetlands exist
within 300 feet of leaching facility) Feet
FURNISHED BY
ej
3- 3® 7- s
3 b
*3 d- �
i V/7
LOCATION SEWAGE PERMIT NO.
V I L L A G E 10,
INS TA LLER'S NAME i ADDRESS
IVILDER //OA�R OWNER
f�
DATE PERMIT ISSUED
DATE COMPLIANCE ' ISSUED
� vr �
�� 5
� � �
c3 r
� ..t v���