Form Aq-68 - Application To Reopen Town Relay Area(S) For Recreational Shellfishing - State Of Connecticut

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STATE OF CONNECTICUT
DEPARTMENT OF AGRICULTURE
Bureau of Aquaculture and Laboratory
APPLICATION TO REOPEN TOWN RELAY AREA(S) FOR
RECREATIONAL SHELLFISHING
Permittee:
License No:
Town:
Town Code No.
Applicant:
(Print name to appear on certificate)
Address:
(Street)
(City, State, Zip Code)
Telephone:
(business)
(emergency)
Kind of shellfish: Oysters, Soft Clams, Hard Clams, Mussels (circle)
Areas where relayed shellfish are to be harvested (describe areas)
I certify that the shellfish relay operations for the above area ceased on
, and that the
shellfish have remained on these grounds for at least 14 consecutive days with a water temperature
of 50 degrees F or greater.
I agree to conform to all requirements of the Connecticut Public Health Code and understand that
any person making a written false statement on this application shall be subject to arrest as provided
for in Section 53A- 157 of the Connecticut General Statutes.
Signed by:
Title:
Date:
Date of Birth:
NOTE: The harvesting of shellfish from any areas not approved for the taking of shellfish by the
Connecticut Department of Agriculture, Bureau of Aquaculture renders the violator subject to
prosecution under the provision of Section l9a-98 of the Connecticut General Statutes.
AQ-68 (Rev. 7/92)
.pdf

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