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Board of Appeals — Board of Health — Planning Board — Conservation Commission — Building Department
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DESIGNER 'S CERTIFICATIOR
This is to certify that the subsurface sewage disposal system
installed at /p EST 57- - _ , Subdivision Lot No.
Town Bot No. and Town Kap No. has been installed
in strict accordance with the plans and specifications approved by
the AMMWMP Board of Health. This certification includes the location,
grades and materials of all components of the system.
3aAs e 6/1
H1H OF
Note: This must be delivered to theeal eal J
Board of Eealth within. 48 hours
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following the approving inspection. No.