HomeMy WebLinkAboutMiscellaneous - 11 APPLEDORE LANE 4/30/2018 J 11 APPLEDORE LANE
210/097.0-0079-0000.0
Address 4,,, Title of File Page of
Date File Open: Date file closed:
Doc Document/Action Title Date of Refer to other Purpose of Document/Action and notes.
action Document/ document/
Num. Action Department
Board of Appeals - Board of Health - Planniiag Board - Conservation Commission - Building Department
WATERSHED RESIDENTS QUESTIONNAIRE
1. Name
2. Street Address 7 �~ �' L t/
3. How many members are in your household? /
i
4. What type of sewage disposal system do you have?
❑ cesspool
❑ septic tank and leaching area
connection to municipal sewer
❑ other (describe)
❑ do not know
5. Are the plans (drawings) for your sewage disposal system on file with the Board of Health?
El yes ❑ no a— do not know
6. How old is your sewage disposal system? ❑ 0-5 years 21' 6-10 years ❑ 11-20 years
❑ over 20 years ❑ do not know
7. Has your sewage disposal system been rebuilt or repaired?
❑ yes C` no ❑ do not know
If yes, approximately how long ago? years. What was done?
8. How frequently is your sewage disposal system pumped out? ❑ annually
❑ every 2-4 years ❑ every 5-10 years ❑ over 10 years ❑ never
9. Have you had any problems with your sewage disposal system? ❑ yes 9— no
If yes, what problems?
❑ repeated pump-outs needed
❑ system clogs, backs up, or drains slowly
❑ odors
❑ sewage surfaces through ground
10. How many of each appliance are connected to your sewage disposal system?
washing machine dishwasher garbage disposal
dehumidifier drain sump pump toilet
roof/pavement drains showeribathtub '�
11. Please state the brand and type (liquid or powder) of detergent you use for:
dishwasher CA j r 4d 6-
clotheswasher C p'-,4, L (j
12. Does your property have a lawn? El'yes ❑ no
If yes, approximately what size?
❑ less than 1/4 acre_ Z�'1/4 acre ❑ 1/2 acre ❑ 3/4 acre ❑ 1 acre
❑ more than 1 acre (Specify) acres
13. How often do you fertilize your lawn?
n?
No. of applications per year
Season(s) of the year � '/.�//VG %� r,41Z
14. Please state the brand and type (liquid or granular) of lawn fertilizer you use:
❑ Check here if your lawn is maintained by a professional landscape contractor.