HomeMy WebLinkAbout4257 MAIN ST./RTE 6A(BARN.) - Health 425TMain Street/Rte 6A (Bairn)
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BOARD OF HEALTH
TOWN OF BARNSTABLE
2pplicat ion for VeYf Con.5trurtion Permit
Application is hereby made for a permit to Construct Wl, Alter ( ), or Repair ( )an individual Well at:
Location — Address — Assessors Map and Parcel O
Owner Address
R
Installer — Driller Address
Type of Building
Dwelling --------— --- --
Other - Type of Building--- ------ No. of Persons---------------- ------------
t° I?V GJ�C.L. �09,orn) Capacity-
Purpose — - --—-_--- --—
Type of Well-- ----fir of Well---41'20 ---
Ln��
Agreement:
The undersigned agrees to install the aforedescribed individual well in accordance with the provisions of The
Town of Barnstable Board of Health Private Well Protection Regulation - The undersigned further agrees not to
place the well in operation until a Certificate Compliance has been issued by the Board of Health.
Signed Zo1_-
` c Q date
Application Approved By - -�----
date
Application Disapproved for the following reasons:
�--� ---------------date--_—_
Permit No. ! - Issued------ --- ---- -- ----
date
BOARD OF HEALTH
TOWN OF BARNSTABLE
Certificate ®f (Compliance
THIS IS TO CERTIFY, That the Individual Well Constructed ( ), Altered ( ), or Repaired ( )
by— — ---- --- --— —----
-� Installer ---_----- —_---
at ---------- -— —_ _—__—----has been installed in accordance with the provisions of the Town of Barnstable Board of Health Private Well Protection
Regulation as described in the application for Well Construction Permit No. �Dated -�--��-
I
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL
SYSTEM WILL FUNCTION SATISFACTORY.
DATE-- Inspector-------------- -- ----
No.-- Fee-
BOARD OF HEALTH
TOWN OF BARNSTABLE
Applicat ion-*r Vell Con5truct ion Permit
Application is hereby made for a permit to Construct (r'), Alter ( ), or �ep,�it ( )an individual yell at:
�—— Location — Address Assessors Map and Parcel
--- ------------
Owner Address
Installer - Driller Address
Type of Building
Dwelling - S�- ---—---—-
Other - Type of Building-- ------. No. of Persons-------------,="==—i-----
Type of Well z4" 9V5• WG.L-L ��pn) city
Al
—- ------- --
Purpose of Well-- 4, i v —
Lnuan-
Agreement:
The undersigned agrees to install the aforedescribed individual well in accordance with the provisions of The
Town of Barnstable Board of Health Private Well Protection Regulation - The undersigned further agrees not to
place the well in operation until a Certificate Compliance has been issued by the Board of Health.
Signed __ — - c:IL L-7- —
., � date
- G . ��� \
Application Approved By -------- �-�-c ---
date
a
Application Disapproved for the following reasons: -------------------------
§ f date
n V -- ---- -
Permit'`No.{ Issued
date
BOARD OF HEALTH
TOWN OF BARNSTABLE
Certificate ®f Compliance
THIS IS TO CERTIFY, That the Individual Well Constructed ( ), Altered ( ), or Repaired ( )
by--- —_----- ---- ----- ------- - -- - --- --- --
Installer
at
!, has been installed in accordance with the provisions of the Town of Barnstable Board of Health Private Well Protection
Regulation as described in the application for Well Construction Permit No. GN bU t-r2 Dated---
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL
SYSTEM WILL FUNCTION SATISFACTORY.
DATE----- - Inspector—__----- - ----- — ----—--
BOARD OF HEALTH
TOWN OF BARNSTABLE
lVell Con5truct ion Permit
No. �UU'� � Fee-
I
' Permission is hereby granted -- - ------ —-to Construct V), Alter ( ), or Repair ( ) an Individual Well at:
\ Street
as shown on the application for a Well Construction Permit
No. ( W' ' -- Dated--- 1^ ---_----- -- -
�^ Board of Health
DATE—
p
TOWN OF BARNSTABLE
tom?,
.00ATION 6A SEWAGE # ?/s X7.5-
VILLAGE ASSESSOR'S MAP & LOT
INSTALLER'S NAME & PHONE NO. �L��, �t�o'� , off[• 3�1-gml.'57
SEPTIC TANK CAPACITY
LEACHING FACILITY:(type) (:o- ;7u%*S(size) `
NO. OF BEDROOMS_ PRIVATE WELL OR PUBLIC WATER &6!�%c
BUILDER O OWNER
DATE PERMIT ISSUED:
DATE COMPLIANCE ISSUED: � `?�
VARIANCE GRANTED: Yes No
�f►
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�- 3
2
w
y
No... j
._.... / FICs...........�ao
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
TOWN OF BARNSTABLE
Appliration for Disposal Works Tonstrnrtinn 1hrmit
Application is hereby made for a Permit to Construct ( ) or Repair (V/) an Individual Sewage Disposal
System at:
_ i
.. `_. �
��-Ad ress No.
.. � - Zen? C
-_
Address `
Installer Address
dType of Building Size Lot----------------------------Sq. feet
U Dwelling—No. of Bedrooms.--...__.... .....................Expansion Attic ( ) Garbage Grinder ( )
Other—T e of Building No. of persons............................ Showers — Cafeteria
Q, Other fixtures
--------------------------------------------------------------------- --------------------------------
-
W Design Flow............................................gallons per person per day. Total daily flow............................................gallons.
1:4 Septic Tank—Liquid*capacity............gallons Length................ Width................ Diameter--.--.-.----_-- Depth................
Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area.---.---__-_.--.....sq. ft.
Seepage Pit No--------------------- Diameter.........-.......... Depth below inlet.................... Total leaching area..................sq. ft.
Z Other Distribution box ( ) Dosing tank ( )
Percolation Test Results Performed bY..................................................•........................ Date........................................
Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water...................
LT4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
a --••----------------------•--•-----•-----•-----------------••--••--•-••-•-•------•-----------------------------------•-----.................................
0 Description of Soil...............................................................................=........................................................................................
x
V •-•.........--•-•----•-------•-------------•--------...-------•------•-----------••---------------•-.....•--•••--•-••-•-----•-••-•--••••-------------••------•----------------••---------•-•••-•----•---
W -•-------•-------------------•-•-•-••-------------------•--•---------------------------••••-•--•-••----- ------------------------------------ -
V .- Nature of Repairs or Alterations—Answer when applicable � -----L �7 .....
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the
system in operation until a Certificate of Compliance has been issued by the board of health.
i ned --------
----------------- ---------
.._. '.w
C+'
Application Approved By 4�
Date
Application Disapproved for the following reasons- ------------------------------------------------------------------------....... -----------
-------------------------------------------------- -- ------------------------------------------------------------------------------------------------- ---------------------------------------- ----------------------------------------
Date
PermitNo. ---------7/-- ;� -----76 ---------------- Issued ----------------------------. -------- --------------------------
Dare
No.._a l ..: / Fizs....�`�
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
TOWN OF BARNSTABLE
Appliratiou for Disposal Works Toustrnrtiun ramit
Application is hereby made for a Permit to Construct ( ) or Repairs(Wan Individual Sewage Disposal
System at: `
............... _........ .�� 1 ---'-----•---••--------- ...........................�--� �� 9 �,, W J ,
.»»....» .. .., - ... ..y
!/yf'i %I9�jNi°�N f f/ °
._.........~..._.». ... ...................................... ..... -----•------------------------- ----•------------------...._......
7��Ow�ner Addres<sQ J
w G C_ i(//<<s iL/ �Cl/ �..t.{�n�7'
---------- ----------------- -----�............;
Installer Address
d Type of Building � Size Lot............................S q. feet
V Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( )
Other—T e of Building No. of persons............................ Showers — Cafeteria
Pa Other fixtures --------------------------------------••-_.... f
w Design Flow............................................gallons per person per day. Total daily flow............................................gallons.
9 Septic Tank—Liquid*capacity............gallons Length:............... Width................ Diameter---------------- Depth................
Disposal Trench—No..................... Width.....:......:........Total Length.................... Total leaching area.....................sq. ft.
Seepage Pit No----_--------------- Diameter.. Depth below inlet.................... Total leaching area..................sq. ft.
Z Other Distribution box ( , ) Dosing tank ( )
Percolation Test Results Performed by.......................................................................... Date........................................
Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water........................
rX4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
94 •-------------------------------•-•----.....----•---------------•---..._..._----•---.............---.........................................................
0 Description of Soil................................................................................:........................................................................................
U --------------
----------------------------•-----------------------------•------•-----•-j------------- a 4
W :• -------------
U/W G..... L��s �� �L✓
U Nature of Repairs or Alterations—Answer when applicable_______________________________________. _�,. ._....._.....___..__...._._.__._...____.__.
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal.System in accordance with
the provisions of TITLE 5 of the State.Environmental Code—The undersigned further agrees not to place the
system in operation until a-Certificate of Compliance, as been issued by the board of health.
Signed Y!±'% v! f �j
D'
- -
Application Approved By ---.-.- .-...- /^)
D re
Application Disapproved for the following reasons- ------------------------------------------------------------------------------------------------- ------------------------------ ---
------- ----------------------------------------------------------------------------------------------- ----.......................................................------------------------------ ----- ..................................
to Permit No. ............-a/-----
. ............ Issued ..............---------------.......................................
Dace
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
TOWN OF BARNSTABLE
(fPr#ifira a of C omplinure
THIS IS TO-CERTIFY That the Individual Sewage pisposal System constructed ( ) or Repaired (
by . .... .......................................... .............................................................:............................................................. . -----------------------------------------------
at "- J ��....._----------- ..w, /.................. Ins:Iler..._�.....sr..!'.. ....... aL1........... !..'.f. 1.... ...................
has been installed in accordance with the provisions of TITLE S of The State E vironmental Code 's dSc ibed in
the application for Disposal Works Construction Permit No. .........��J.......:2 �... dated ---... Z �J.... ..........
THE ISSUANCE HALL T BE NSTR ED A A GUARANTEE THAT THE
SSU NCE OF THIS CERTIFICATES NO CO U S
SYSTEM WILL FUNCTION
��SATISFACTORY.
DATE.. ". �:_=../ /------------- ------------------------------- Inspector .................. ...... ...................................................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
�� _ ��� TOWN OF BARNSTABLE �c7�
No._._....r............... FEE........................
Map tt Marko Tung ;ndw- n `' jr. t
Permission is hereby granted... . .............................................................
to Construct ( ) or Repair ( an Individual Sewage tsposal System /J
at No..........�.Z:-----.....-•-•----•----•- � ./,,Psf_.....��,
._�
Street
as shown on the application for Disposal Works Construction Permit No...+ �L�_,2 Sated-------
�i..Z`�l..................
Board of Health
DATE .. . .............................
FORM 36508 HOBBS&WARREN.INC..PUBLISHERS
TOWN OF BARNSTABLE
`L�1(:ATION h� 2- �VT�- SEWAGE #
VILLAGE COM'" 49 u'.o ASSESSOR'S MAP & LOT 350 9�!2 dU?
INSTALLER'S NAME & PHONE NO. �A� 0ia r q_rt""j o 3% "f4 79
SEPTIC TANK CAPACITY /5-00 'vrc
LEACHING FACILITY:(type) tca� D�6furol-' (size)
NO. OF BEDROOMS 3 PRIVATE WELL OR PUBLIC WATER w �
BUILDER OR OWNER �► N��E'z �as�°i' Gtp `z-
DATE PERMIT ISSUED:
DATE COMPLIANCE ISSUED: 6; �� 0
VARIANCE GRANTED: Yes No
C
91J7
0
e CG
N
-P
• C
1t �
0
I
. ASSESSORS MAP N0: �� � � Fes$
No.R.Y.._.� ............................
BOAR® OF HEALTH
/[lLel/t- - -----------------OF......il�...rMla..461G.
App iratinn for Uhgpo i ai Morks Towitrnrtion ramit
Application is her¢bb made for ,Per t Co®truct (X) or Repair ( ) an Individual Sewage Disposal
System at:
-]f-� �
c4 -------- . - �.. ------....L�r.z... •-••••---•••--•-• ---• ------
�i U jWELocation-Addre ,� --- or Lot 'v o.
P...... .l ..... .� 1� ...........1' ..... .-----•...............•-----•-----..........---•------------
Owner Address
.......... Y.....
�ll/?2ld1FiCFjL.IdG-
Installer Address
Q Type of Building Size Lot---b,t'�.Z_._�.._...&+_Iwat
U Dwelling—No. of Bedrooms.....Z .t"C-=........•.............Expansion Attic (A/®) Garbage Grinder 41,15)
Other—T e of Building No. of persons............................ Showers — Cafeteria
Q' Other fixtures __________________________________
Design Flow..................................SS._gallons per person per day. Total daily flow---_------.__-..-----_--a3_0.....gallons.
1:4 Septic Tank
. . Diameter _ Depth"�k.."'-� _
Disposa �—No.�r..41-8 ... Width �........... Total Length.._.?<$'---•..... Total leaching area._a_V.i' sq. ft.
Seepage Pit No..................... Diameter-_-____---__--_-.._- Depth below inlet.................... Total leaching area..................sq. ft.
Z Other Distribution box K ) Dosing tank ( )
~' Percolation Test Results Performed by..6i-u%-�.W.i-I�a...... "fmc.t.Mb�......_. Date-..k� <3 .................
al Test .Pit No. I.....L_______minutes per inch Depth of Test Pit----1.13�`!...... Depth to groun water--------- - ---------
Test Pit No. 2.............`.minutes per inch Depth of Test Pit.................... Depth to ground water ®�
OtF�.fsloly.�i 1^�11L.�.�........... . ---
Description of Soil... t caaS� Si�n�l..$i�l. �8 (�� e'.r?en V�..e---------------------- g STF.RktEN =
Vwfe ,gym_. cw►aIQ._ ... t'taJ-d.j.._�2�Pu_"-1 _ ��., %d. ............................................................Cj ......ALk ------ �^
WILSON
UNature of Repairs or Alterations—Answer when applicable.-----------------------------------------^........................ �No.$ s
Agreement:
j The undersigned agrees to install the aforedescribed Individual Sewage Disposal System i accordance with 1411 el
the T provisions of T T!.T`.
p 5 of the State Sanitary Code—.The undersigned furti:er agrees not to place the system in
operation until a Certificate of Compliance has been issued by th board of health.
s �a
Signed---- . ----- ._ _.. . -------------•---•---••--- �l U
8 Date.....-
Application Approved By.-- -- ..••. �•--•--•. -------- 1..... -� F e .
Application Disapproved for the following re - ns:------••••••----------------•-••----•-----------••-•--------••--•••---••--•---....•---•---•-•••-----..._---•--•.
• . . . .-•---•------•-•••-•-••••--•-•-••----••------••-••---•-•....
Date
Permit No...... ........ ------------------ Issued_..... f�.___. -
Date
T, • y7
No..Iz....... -• F:ms..�--�.�.-.:�-...+r
THE COMMONWEALTH OF MASSACHUSETTS
- BOARD OF HEALTH
-----7acrJ./(_....................OF...... .�r/ .fW` .....
Appliratiun for Disposal Works Toustruriiun Frrutit
Application is hereby made for a Permit to Construct (X ) or Repair ( ) an Individual Sewage Disposal
System at• J 1 0
onl
....................................................------------- - ......------------------------------........ ---- --------------------....•..-------------•----.
t-.j - �`Location-yA�ddre or Lot No.
.! �Ui4i�C\�C4+' ,i�N�t 71� �G..CJ'rG GAP
.............. ...................................... ...... ............ ..............._.?...._..._._. ........._....._..............___....._..........._...............
` Owner / Address
W1\ l /Q C l_/w Q ........0/l_•✓IiYIGi l:(.J�_ ._.:-•----------•--
................•----------•--.......----•----•--•....................
Installer Address
U Type of Building Size Lot__3._.G...
1__L_---_--8, -feet
Dwelling—No..of Bellr'ooms.._.�r"�G.........•.............Expansion Attic (�r�) Garbage Grinder
aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( )
P4 Other fixtures . ;�.... '= - . .
d . •------•--------------------------------------------------------•--------------------
W Design Flow......................................_._gallons per-person per day. Total daily flow.._..............._......-✓�-' !Q._----gallons.
W .
Septic Tank.—L,Ip-��7 capacity .gallons Lengthl -: .�.. Width;��..... Diameter............... Depths'. .`..
x Disposal h ..... Width... ?j.`a............. Total Length___. ........ Total leaching area f?k6t.._...sq. ft.
Seepage Pit No........ ........... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft.
Z Other Distribution box (C ) Dosing tank ( )
'-' Percolation Test Results Performed by.% �?�.�Jj-1r; .-••-. c.nfz�__tG, Date.. _ 9'..................
Test Pit No. l.._..'�_______minutes per inch Depth of Test Pit...1..._?r_...___.. Depth to groun wat ..........
Test Pit No. 2...............minutes per inch Depth of Test Pit.................... Depth to ground -OF _ -----
O ®-I k"}_�c�}l 11 Svd� ca►1 `� 1.. 4..t cJin� _I } " ,`f!� �.j...
Description of Soil.. `� �`6r '��n. e.._`air�� 1�.` 7� (z!v/1Lv� .e-.. '3 S_TEPHEN
i ..._ Gres!-- f rzr, 12 b' 1°'a > lye f' l .................................................... ALLYN
...........................---•---•---•---•--•-----.........--•---•-------•---............-----••.. ...........................................................Lj...... Na W16
---------- F o4
U Nature of Repairs or Alterations—Answer when applicable.................. .4 . G
--------------------------------------•---------------------------------•-----------............--••----.....---•------------•------------------•••----------•-- �s
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
P1 Y�
the provisions of!^�:I::..� 5 of the State Sanitary Code—The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has been is ued by/tt bo�ealth. /
Signed.. .__. yJ /
Ole(
._ e(v
Application Approved BY f�71�.� ` 6 � , /!
.•... ............................................................ ---- ra! ..:j..
/
Application Disapproved for the following reasons:..................................................................................................................
............................... .-•-- « --.-------------------•-----•-------------------------
. ( ., �._...----••�--•---------------------- Date
j� C.
Permit No.__..1 1._ .._. .v.....�___________________.__. Issued---.�9....-��.--51_
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
...... � N........OF........ !�. :� ...
Grtifiratr of (tamp tFaurr
THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ) or Repaired ( )
by....................................•-------•-----•----...---•-----.....--•-•-............-•-..............---------=-•-•---•-----•---•-------------•--•--•------........._..........------••_.....
( y� Instal er
at.. - .... l tl
W - rf r r i f
has been installed in accordance with the provisions of TITLE 5 of The.St Sa ary Co0, described in the
a lication for Disposal Works Construction Permit N o._ C: _-r __....! .
PP P -.. L .... . d� ed---- '
1 / ej
THE ISSUANCE OF THIS CERTIFICATE SHAD NOT BE CO ® S A GUARANTEE TAT THE
SYSTEM ;*IL FUNCTION SATISFACTORY.
DATE.I ..4�.!... ..1 .............................•-•-----.....-----..... Inspector-• . ...........................................................................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD F 1 1,J...T
1..
NO.. .r......... .... FEE.....�.::� .......
DisposalPl�rkii,�onotrtuliou anti#
Permission i� hereby granted.............. �.. 'g � v
/ ....----------•-••....
to Constru•t (� or Repair ( ) an Individual Sewage Disposal„S_- t
in ff
Street /`� r �+
as shown on the application for Disposal Works Construction Permit o.._.....---_- Dated....�!.� .. . ............
f ......----y
Board of Health
DATE................. ......................................
FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS
DA-r A
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to seal t� E opts oi / Loanot L �agi t
lop5oi) � � �TUpsoll E lopsp�l
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511+y,stony 24 -94,4 Z4 - - c/8, / Z - - I03,B 2 - - 100,4
grave) AI}crnu4�.� ..- - olg•� 3?"- 1G.7 �ay��r 0/
rave
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Sand a IUz' -93.7 Inc
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DESIGN DATA ;
�.t.tc�lc t=�.vr�� ly: 3 �c��c>wv� � /(�p�c.cr�bagc 9raric�cr'
�\
Dc<.���-t t=low 3 x I I O = 33cGpD
z.)c4,,tIC. Ta 15Q7o : 495 G- II �
U 1 SOa GA LION
9�`j . Ztach cazcr.'7iy.;._:7hrcc_ 4 ,� o� o/. rsors -t��.Z'_s .tG
\ of<wcll 7e Six Z,SGra/sr = /ao GPD
,Z o i 2 V 7i,o' -.ottnvri
Z24 SF x 1,o G1;,.:1 /..r i Z24 GP U
3. 2 ,l�Gres
296 >F 404 GPD
Q uSt `»anhv/, coder, 7b io vr�ciiif)yri
PcastCS
CO
FG• _/O3
o
all
l 5p p /A/v
//VY
t\ \ \ / 4 x 8
3 Tan K q
\ \ 8
r
IF ENCOUNTEREDc ALL UNSUITABLE SOIL
SHALL BE REMOVED WITHIN A 10' WIDE
1 / , ZONE AROUND THE LEACHING FACILITY
\
AND SHALLBE REPLACED WITH CLEAN
/O ,. SAND AND GRAVEL IN ACCORDANCE WITH
TITLE V.
Qry scrVt..A
N
ILI
1010
10,
N.
!
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,ob '"' o' �' `� �'/�/ / ► \I \ / �t�''� SSEP71C JYSTEM ,[)ESIGtiI
1 7- ROUTE-
0
Z Ccr+4,1 -1- N ha+ - La. poopo Th cc
sccQ Noose is "0/4N /.S n .e basedrs o dh Lo
crc n comljiye, wl ++A +he //!`.17cJ.rl<c� t` JcJr yr U.,41 0'4c a -
/CAO�-� i' /o// �idGl�n¢ G�tcP S[tbkelC rec�v�rer��c.�i�S s'ef5 how. h<rco.? s/iou/c0 ,jot` CUMMAQU/Z:) / MA
/qti j/ ii Qf }iu low�n o f '�cr ,s+T.hlc cc��d� is b� c�sta� c:�rtL✓/i5ir /OZ` �ir1C.S.
��0 not IOcc.tcdl cc +lvutfpla10 CHRNDL.ER 130SWORTN
t ; DATE . Avjvist
STEPHEN
A. At "
OJCAI.E I = 50 `� Hr"J,TEFl WILSON BAxTER NYE, INC ,
s� No.24048 �Y No.30216�(' Regis refit hand Su r�e yor5
Civil Eh�i n e e rr 5
is / /j ' LAND (,/ C�S TER V I L.l.E 1 / )f}S,5
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