HomeMy WebLinkAbout- Permits - 27 BRADFORD STREET 3/12/2002 Town of North Andover, Massachusetts Form No. 3
„ORTIy BOARD OF HEALTH
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DISPOSAL WORKS CONSTRUCTION PERMIT
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Applicant
NAAMEy ADDRESS TELEPHONE
Site Location / 'l l" � S
Permission is hereby granted to Construct ( ) or Repair ( an Individual Soil Absorption
Sewage Disposal System as shown on the Design Approval S.S. No. �� 7
CHAIRMAN, BOARD OF HEALTH
Fee ��D D.W.C. No. � ` ��
BOARD OF HEALTH
NORTH ANDOVER, MA 01845
978-688-9540
APPLICATION FOR DISPOSAL WORKS CONSTRUCTION PERMIT
DATE: CURRENT INSTALLER'S LICENSE#
LOCATION: r_ -
LICENSED INSTALLER:
SIGNATURE: ' TELEPHONE# �. G
CHECK ONE:
REPAIR: NEW CONSTRUCTION:
IF NEW CONSTUCTION, PLEASE ATTACH FOUNDATION AS-BUILT.
Administrative Use Only
$160.00 Fee Attached? Yes /f No
Foundation As-Built? Yes No
Floor Plans? Yes No
Approval //�C�j�� Date: /� G