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33 Septic Permit Appiic 'OMMON'WFALTI.I OF MASSAGIUSFTIS Board of Ifvalth, MOtrNAMa+TO '% MA. APPLICATION FOR DISPOSAL SYSTEM CONSTRUCTION 1?IT; IIT ion for a Benoit to Construct( Repair(g) Upgrade( ) Abandon( ) - gComplete System 7 Individual Components Type of Building bwELC IU 6 Ds.elliug-No.Of Bedrooms Other-Type of Building Other Crum*: No.of peso Lot size /A.Soo sq.fa Garbage grinder ✓6 Showers ( ).Carete,is ( ) Design Flow (min. required) 110 Plan: Date 7118 10 Title Du.)G Yt ools7 ?DR Description of Soil(5) Poe. sawn Soil Evaluator ha No. gpd Calculated design now 330 Numher of sheet. 2. Design flow provided a 7S gpd Ret isiou Date 1- F,ve Si4ry 3AAA 8�z9�oo Name of Soil Evaluator?F SNEEArAd1 3 -Date of Eva ltw ion DESCRIPTION OF REPAIRS OR AI.PERAI IONS NLW /SOO £A//essl S6pric 7ANt/ j1-UM�' ei4m t , L£A(N Zc7 PILL RtOoiQCh agrees to install the above described Individual Sewage Disposal System in accordance with the pro imp _„, .... „ . 1,.. .. ..t: t.,,,,i±„.„ \ �4:�lYrtf1" \try The undersigned g gr finch agrees to not to p ce the system in operation until a Certificate of Compliance has been issued by the .. , . e aY R-PS re Date 9/18)00 Signs of TITLE 5 and Lisp Inratien 33 Auronnl DP-10t, Owners Name Doaatb 6eNde-OA Nap/Parcel# Addreas 33 AJTum&) lelJC l.ot# Telephone# j-g 65-71 Installer sNan,e �L rFveY-bYl � t DesigoersName g. F. SHfe.a.) ASSOC iue w aria.. 1, adrhess/y6 7gyectsr 6evuay MA Address I - Telephone# Telephone* - 7d1 /""""9" 91/3 Y67 -e_ Type of Building bwELC IU 6 Ds.elliug-No.Of Bedrooms Other-Type of Building Other Crum*: No.of peso Lot size /A.Soo sq.fa Garbage grinder ✓6 Showers ( ).Carete,is ( ) Design Flow (min. required) 110 Plan: Date 7118 10 Title Du.)G Yt ools7 ?DR Description of Soil(5) Poe. sawn Soil Evaluator ha No. gpd Calculated design now 330 Numher of sheet. 2. Design flow provided a 7S gpd Ret isiou Date 1- F,ve Si4ry 3AAA 8�z9�oo Name of Soil Evaluator?F SNEEArAd1 3 -Date of Eva ltw ion DESCRIPTION OF REPAIRS OR AI.PERAI IONS NLW /SOO £A//essl S6pric 7ANt/ j1-UM�' ei4m t , L£A(N Zc7 PILL RtOoiQCh agrees to install the above described Individual Sewage Disposal System in accordance with the pro imp _„, .... „ . 1,.. .. ..t: t.,,,,i±„.„ \ �4:�lYrtf1" \try The undersigned g gr finch agrees to not to p ce the system in operation until a Certificate of Compliance has been issued by the .. , . e aY R-PS re Date 9/18)00 Signs of TITLE 5 and Lisp