HomeMy WebLinkAboutMiscellaneous - 290 BARKER STREET 10/28/2015 (2) I
SEWER MAINS TELEPHONE
WATER MAINS 6£33-6791
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ROADS Ramey Contractors s ° Engineers, c.
EQUIPMENT RENTAL
ENGINEERING 33 OAK KNOLL ROAD
METHUEN, MASSACHUSETTS
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SEWER MAINS TELEPHONE '...
WATER MAINS 683-6791
STORM DRAINAGE
ROADS Ramey Contractors ® Engineers, Inc.
EQUIPMENT RENTAL
ENGINEERING 33 OAK KNOLL ROAD
METHUEN, MASSACHUSETTS
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SEPTIC SYSTEM INSPECTION FORM
ADDRESS 2-
DATE INSPECTED _..�
PROPERLY FUNCTIONING? Y N r
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DYE TEST PERFORMED? Y N
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FORM II IDT REIEME FORM
INSTRUCTIONS: This form is used to verify that all necessary
approvals/permits from Boards and Departments having jurisdiction
have been obtained. This does not relieve the applicant and/or
landowner from compliance with any applicable local or state law,
regulations or requirements.
****************Applicant fills out this section*****************
VAPPLICANT: 1,1�1 L - �_��� Lc;�L ��r. ("7t'o501-J Phone �-�t�
LOCATION: Assessor' s Map Number Parcel
Subdivision Lot (s)
/Street 121, 1�' C7 St. Number cy
************************Official Use Only************************
RECOMMENDATIONS OF TOWN AGENTS:
Date Approved
Conservation Administrator Date Rejected
Comments ;
Date Approved
Town Planner Date Rejected
Comments
Date Approved
z F od Inspector-Health Date Rejected C,
N 1A LL _S Date Approved
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Septic Inspector-Health Date Rejected
Comments
Public Works - newer/water connections s
driveway permit
/Fire Department
Received by Building Inspector Date
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Form 4o.3
Town of North Andover, Massachusetts
BOARD OF HEALTH
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DISPOSAL WORKS CONSTRUCTION PERMIT
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TELEPHONE
Applicant ADDRESS
NAME
Site Location
ranted to Construct ( ) or Repair�an Individual Soil Absorption
Permission is hereby g App roval S.S. No.
Sewage Disposal System as shown on the Design
4HAIRN BOARD OF HEALTH
D.W.C. No.
Fee
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