HomeMy WebLinkAboutApplication - 492 SALEM STREET 5/12/1999 Town of North Andover, Massachusetts "Form No.Z
poRrly BOARD OF HEALTH
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A
-+r"� DESIGN APPROVAL FOR
SsACHUSES SOIL ABSORPTION SEWAGE.:DISPOSAL SYSTEM
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A licant 0— Test No.-
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Site Location
Reference Plans and Specs. r /(
ENGINEER{ DESIGN DATE
Permission is granted for an individual soil absorption sewage disposal system to be installed
in accordance with regulations of Board of Health.
MAIRNIM.BdARD OF HEALTH
Fee Site System Permit No.1
May-27-99 12 : 45P Nor—th Andover Cam. Dev . S08 688 9542 P . 01
SEPTIC PLAN SUBMITTAL FORM
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NT:\V PLANS: Yi $125.00/11Ian
REVISED PLANS: YES S 60.00/111an
SITE EVALUATION FORMS INCLUDED: YES
DATE: '. t"7 +
DESIGN ENGINEER: /01:�/ t t.11-I I, i_" t ✓� c'W C t;Ur ,_—. ._
DATE TO CONSULTANT: / ✓'�
*If you want your plans expedited, please submit three plans and included a
stamped envelope with the correct amount of postage to mail plans to fort
Engineering.
When the submission is all in place, route to the Health Secretary.
SEPTIC PLAN SUBMITTAL ITTAL FORM
LOCATION:
NEW PLANS: YES $125.00/Plan
REVISED PLANS: YES $ 60.00/Plan
SITE EVALUATION FORMS INCLUDED:
DATE:
DESIGN ENGINEER.
: �c
DATE TO CONSULTANT: // r
*If you want your plans expedited, please submit four plans and included a stamped
envelope with the correct amount of postage to mail plans to Port Engineering.
When the submission is all in place, route to the Health Secretary.
i
May-27-99 12 : 45P North Andover Com. Oov . 508 688 9542 P . 01
! U E y T C PLAN S 4 BqITT L FORM
1 1
LOCATION: _.. _
N-EW PLANS: YLS SI2�,00/flan
REVISEll PLOWS: YF S S 60.00/1)1an
SITE EVALUATION FORMS INCLUDED: /4 E5
) NO
DATE: -------
DESIGN ENGFNEER: l t
l
DATE TO CONSLrLTANT:
*If you want your plans expedited, please submit three plans and included a
stamped envelope with the correct amount of postage to mail plans to Tort
Engineering.
When the submission is all in place, route to the Health Secretary.