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Massachusetts Department of Environmental Protection
L71Bureau of Resource Protection - Wetlands
WPA Form 5 - Order of Conditions
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
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A. General Information
From:
North Andover
Conservation Commission
This issuance if for (check one):
® Order of Conditions
❑ Amended Order of Conditions
To: Applicant:
Scott Talbot
Name
102 South Bradford Street
Mailing Address
North Andover MA. 01845
City/Town State Zip Code
1. Project Location:
70 Oakes Drive
Street Address
Map 107A
Assessors Map/Plat Number
2. Property recorded at the Registry of Deeds for:
Essex North
County
DEP File Number:
242-1226
Provided by DEP
Property Owner (if different from applicant):
Same
Name
Mailing Address
City/Town
North Andover
City/Town
Parcel 144
Parcel/Lot Number
7986
Book
State Zip Code
Certificate (if registered land)
3. Dates:
11/21/03
Date Notice of Intent Filed Date Publit Hearing Closed Dat of Issbance,
104
Page
4. Final Approved Plans and Other Documents (attach additional plan references as needed):
NO[
111/21/03
Title
Date
Proposed Subsurface Sewage Disposal System -Sheets 1-2
10/14/03
Title
revised
11/20/03
Title
Date
5. Final Plans and Documents Signed and Stamped by:
Richard C. Tangard P. E.
Name
6. Total Fee:
$250.00
(from Appendix B: Wetland Fee Transmittal Form)
Wpaform5.doc • rev. 12/15/00
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