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HomeMy WebLinkAboutSeptic Resubmittal - Receipt - 37 SCOTT CIRCLE 10/26/2021 i Of MORTN,y 9 I 6 O j • ` Town of North Andover j •r HEALTH DEPARTMENT j ,SSACNUS�� CHECK#: 0 DATE: Zo LOCATION: ,�2 _�Ln�-1 l�i,�,j�. H/O NAME: /7)We,'- CONTRACTOR NAME: Type of Permit or License: (Check box) • Animal $ ❑ Body Art Establishment $ ❑ Body Art Practitioner $ ❑ Dumpster $ ❑ Food Service-Type: $ ❑ Funeral Directors $ ❑ Massage Establishment $ ❑ Massage Practice $ ❑ Offal(Septic)Hauler $ ❑ Recreational Camp $ ❑ Sun tanning $ ❑ Swimming Pool $ ❑ Tobacco $ ❑ Trash/Solid Waste Hauler $ ❑ Well Construction $ SEPTIC Systems: ❑ Septic-Soil Testing Septic-Design Approval i r, ❑ Septic Disposal Works Construction(DWC) $ ❑ Septic Disposal Works Installers(DWI) $ ❑ Title 5 Inspector $ ❑ Title 5 Report $ ❑ Other.(Indicate) $ hj!alth Agent Initials 1 White-Applicant Yellow-Health Pink-Treasurer