HomeMy WebLinkAboutApplication - 295 FOREST STREET 4/30/1999 Town of North Andover,Massachusetts Form No.a
poRTh BOARD OF HEALTH !n1
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DESIGN APPROVAL FOR
ass"C"U5`t� SOIL ABSORPTION SEWAGE DISPOSAL SYSTEM
Applicant ' Test No
Site Location
Reference Plans and Specs.
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ENGINEER ESIG DATE
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 f
Fee ` �c� Site System Permit No.' ��
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SEPTIC PLAN SUBMITTAL FORS
LOCA TION:
NEW PLANS: YES $125.00/Plan
REVISED PLANS:
YES $ 60,00/Plan
SITE EVALUATION FORMS INCLUDED: YES NO.
DATE: Z �--7z
DESIGN ENGINEER: � , 2��6�4
DATE TO CONSULTANT:
When the submission is all in place, route to the Health Secretary.
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SEPTIC PLAN SUBMITTAL FORM
LOCATION:
NEW PLAINS: YES $125.00/Plan
REVISED PLANS: YES 60.00/Plan
SITE EVALUATION FORMS INCLUDED: YES NO
DATE: VJ!F �-
DESIGN ENGINEER: /��/7 ? % n)
DATE TO CONSULTANT:
*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.
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