HomeMy WebLinkAboutMiscellaneous - 351 WILLOW STREET 9/14/1997 - FORM U - LOT RELEASE FORM
INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from
Eeards and Departments having jurisdiction have been obtained. This does not relieve
the applicant and/or landowner from compliance with any applicable or requirements.
**<* APPLICANT FILLS OUT THIS SAC T f0N** ********.*.
APPLICANT I PHONE.
—' PARCEL
LOCATION: Assessor's M30 Number—a57-
umber �5 -
SUBDIVISION LOT (S)
STREET ST. NUMBER c
OFFICIAL USE ONLY"" x*�** � tt**
RECOMMENDATIONS OF TOWN AGENTS: �N(�
DATE APPROVED -7,
CONSERVATION ADMINISTRATOR DATE REJECTED
coMrnENTs
Q� �.5' JI I' rL J-t av
JTORN ANNER DATE APPROVED
DATE REJECTED
COMMENTS
FOOD INSPECTOR-HEALTH DATE APPROVED
- DATE REJECTED
SE°TIC ISP, OR HEALTH DATE APPROVED
DATE REJECTED
COMMENTS
PUELIC `NCRKS - SE'NERIWA T ER CONNECTIONS
DRIVE' AY PERMIT
V//FiRE DE°ARTMEN T
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E EUILSIrIe (SPEC T c