HomeMy WebLinkAboutPlans - 107 GRAY STREET 8/8/2003 Town of North Andover, Massachusetts Form No.2
1 tORT#t BOARD OF HEALTH
X. Ave
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DESIGN APPROVAL FOR
Ss"CHUStt SOIL ABSORPTION SEWAGE DISPOSAL SYSTEM
Applicants-5' f�iL� Test No 1�
Site Location n
Reference Plans and Specs. x W'r'/h1
NGINEER DESIGN
4iLATE
Permission is granted for an individual soil absorption sewage disposal system to be installed
in accordance with regulations of Board of Health.
CHAIRMAN,BOARD OF HEALTH
Fee r/�7L ! Site System Permit No.-/
SEPTIC PLAN SUBMITTALS
4 Map &Parcel/,Q ,/ eATZ-6,
LOCATION:
NEW PLANS: S) $225.00/Plan Check#:
REVISED PLANS: YES $ 60.00/Plan Check#:
SITE EVALUATION FORMS INCLUDED: Y ES NO
LOCAL UPGRADE FORM INCLUDED: YES NO
DATE:-'- DATE TO CONSULTANT:
DESIGN ENGINEER* -. Telephone #:
When the submission is complete (including check), date stamp plans, COPY for
Conservation and place in existing file with green Design Approval Form.
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