Septic As-Built CardTown of Yarmouth 4 ReD zoocoS
Subsurface Sewage Disposal System As -Built Information
Street Address: IS -B ko w t o LANE Map:Q Parcel:I_
Owner Name: Bic) N iso Permit #: 1 -_2 S 50 gir-14 —
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Date Installed: U4 Lolo q
New: Repair:
Installer Name: acO I kw 4-3c Installer Phone: 508- 2.�18 - 664 8
Installation of (list all components, both newly installed and existing to remain in use):
15 0 GAL- . 'ice N K -D f� ��?�1 ID ,x 3 5 LEACA EEA GIQ
Leach Capacity (gpd): '440 Ground Water Depth (inches): Health Inspection by: 8 1