34-031 THE COMMONWEALTH OF MASSACHUSETTS
No. , MASSACHUSETTS Fee
t>a osttX 5Voteut Construction e>rrait
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Permission is hereby granted to a (. ;y
to construct( ) or repair( )an On-site Sewage System located at
and as described in the above Application for Disposal System Construction Permit. The applicant recognizes his/her
duty to comply with Title 5 and the following local provisions or special conditions.
All construction must be omplet d within two years of the date below.
DATE � Approved by
FORM 1255 Rev.3/95 A.M.SUIKIN 4-BOSTON,MA -