225 Permit 2005 Ito.._ _S_01- THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
DISPOSAL SYSTEM CONSTRUCTION PERMIT
Permission is hereby ranted to C. str . (V/ Repair ) Upgrade ( ) Abandon A ) an.i 'vidual sewage
disposal system at _dv i� i z' �/ Lam-. .. .a '..,ii t, ,- cribed
y r)
in the application for Disposal System Construction Permit No. ?OAS'OO dated 03 �S C.
FEE
243d
Provided: Construction Shall be completed within three years of the date of this permit.All local conditions must be met.
Date C/�Y�.LC /S �f/U S Board of Health ill..n LN
DEP APPROVED FORM 5/96
FORM 2- DSCP
FORM 1255 (REV 5/96) CH&W)Hasss WARREN T"
PUBLISHERS- BOSTON