HomeMy WebLinkAboutSeptic As-Built Card Commonwealth of Massachusetts
: * , Title 5 Official Inspection Form
y Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
33 Vacation Lane
•
Property Address
MCDONALD MICHAEL J LIFE EST
Owner Owner's Name
information is every West Yarmouth
required for eve MA 02673 03/16/2020
page. City/Town State Zip Code Date of Inspection
D. 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:
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