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LOC:'A�'ION3641 RTE 6A. SEWAGE # 2004-546
V)?.LAGE BARNSTABL E ASSESSOR'S MAP& LO-IM 317/P41
INSTALLER'S NAME&PHONE NO. ELLIS BROTHERS CONST. CO 508-362-6237
SEPTIC TANK CAPACITY -
LEACHING FACILITY: (type) S®® e + size)
---`10.OF BEDROOMS
BUILDER OR OWNER RALPH STOESSER
PERMTTDATE: 10/15/04 COMPLIANCE DATE: 11 Lo
Separation Distance Between the:
Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet
Private Water Supply Well and Leaching Facility (If any wells exist
on site or within 200 feet of leaching facility) Feet
Edge of or
and Leaching Facility(If any wetlands exist
within 300 feet of leaching facility) Feet
Furnished by
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