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HomeMy WebLinkAboutAs-built showing work to be completed Commonwealth of Massachusetts -z•---------.. Title 5 Official Inspection Form -ziso:-----=----- sub.ffice sewage Disposal System Form - Not for Voluntary Assessments a' , ;441_.=--,:: 6 Itres A- ve .. _ _ _ Property Address Owner Owners Name information is ed for every yler,-,,,,,g-tt requir ..,,. ,---- .-- ---- .---- .-— ;mg city/i own State Zip Code Date of Inspection _ Da System !Information (cont.) 14. Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks, Locate all wells within 100 feet, Locate where public water supply enters the building. Check one of the boxes below: El hand-sketch in the area below , r] drawing attached separately --------------------- ..,-..., - ------- - 0 a 23 klit st, P JUL 2 H 7 2ALT,Li 0 1— , 3 11.11----stiMr" - ..—. - ........„ cep(Ate z i I i 9 ,iiiie a i - a v)c- 1' --•.---- ,,,,,:.,--; ---- e )1 . 644 I-.---, --- — ir - 1 2 6 1 7 __. v , , r.,..„,fin