HomeMy WebLinkAboutApplication - 259 GRANVILLE LANE 3/14/2008 TOWN OF NORTH ANDOVER N0 r"
Office of CDNINtUNIgT`�' DEVELOPMENT AND SERVICE'S
14600 OSG000 STREET; BUILDING 20° SUITE 2-36
';
NORTH /ANDOVER, MASSACHUSETTS 01845 AC US
978.688.9540—Phone
.iusalt Z'. Sawyer,RE118/11S 978.688.8470—FAX
Public Health Director E-MAIL: healthdept@townofnorthandovercom
WEBSITE:httn://www.townofnorthandover.com
SEPTIC PLAN SUBMITTAL FORM
RECEIVED
Date of Submission: r
Site Location: UA TOWN OF NORTH ANDOVER
HEALTH DEPAR-RAENT
Engiiicer:_
New Plans? Yes ✓` $225/Plan Check#-j-Z.430_ (includes I"submission and one re-
review only)
Revised Plans?Yes $75/Plan Check#
Site Evaluation Forms included? Yes v` No
Local Upgrade Form included? A.JA.Yes No
Telephone#: � � �� . '� ._�L' _—.Fax #:���°/
E-mail: H C
Homeowner
Nanlc:
Qk+'I+ICE'USE ONLY
When the submission is complete(including check):
1' ,�✓ Date stamp plans and letter
Complete and attach Receipt
Copy File;Forward to Consultant
Enter on Lo Sheet t
Log t a�d Database
Otmer's Name-
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