41-057 (2) No. )6//o7; THE COM) ONWEALTH OF MASSACHUSETTS FEE 2i/�K) o0
41/11 / BOARD OF HEALTH
DISPOSAL SYS EM CONSTRUCTION PERMIT
Permission is herebygra ted to Coast t ! 1 Re r ( ) Upg-r de ( ) Abandon ( ) an individual sewage
disposal system at p _ / AL /lid/.47 a'described
in the application for Disposal System Construction Permit No. ,26/6 'i 2 ,dated_ p _
Provided•. Construction shall be completed within three years of the date of this permit.All local conditions must .- met.
Date425.71a7/6__. Board of Health_
FORM 2 - DSCP DEP APPROVED FORM S/96 � /
✓""-",e 4R-✓/T
FORM 1255 )REV 5/96)
Cif&W---) HOBBs&WARREN TM PUBLISHERS- BOSTON