HomeMy WebLinkAbout0551 MAIN ST./RTE 6A(W.BARN.) - Health 1
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TOWN OF BARNSTABLE
LOCATION 5�5 I Nlu�,.7 5� Jkt & .A� ° .SEWAGE# -d-01'3 �--1`2_
•PILLAGE (,g)p� _j�pr,)5,�!f ASSESSOR'S MAP&PARCEL 13 3 —0,/
INSTALLERS NAME&PHONE NO:��e;.s A
SEPTIC TANK CAPACITY
LEACHING FACILITY:(type) LC,-(; ('inelt�rs W?0(size)
NO.OF BEDROOMS c�
OWNER
PERMIT DATE:, - o`Z - j'3 COMPLIANCE DATE: 2.
Separation Distance Between the:
Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility pc�� .0 Feet
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'—Zoo� CkACo l c J
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TOWN OF BARNSTABLE L�
LOCATION 551 Main Street JRT 6A) SEWAGE #
VILLAGE West Barnstable ASSESSOR'S MAP & LOT
INSTALLER'S NAME & PHONE NO.
SEPTIC TANK CAPACITY 1000 gallon
LEACHING FACILITY:(type), Leaching Trench (Size)
NO. OF BEDROOMS 1 PRIVATE WELL OR PUBLIC WATER Well
BUILDER OR OWNER Jerrell Cleaves
DATE PERMIT ISSUED:
DATE COMPLIANCE ISSUED:
VARIANCE GRANTED: Yes No XX
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