HomeMy WebLinkAboutMiscellaneous - 474 SALEM STREET 11/29/1999 FORM U - LOT RELEASE FORINI
la`ISTRUCT101�S; This form is used to verify that all necessary approvals/permits from
Boards and Departments having jurisdiction have been obttain , hor does of relte\/e
the applicant and/or landowner from compliance with a applicable
*****************************APPLICANT FILLS OUT THIS SEC T ION'
APPLICANT Pr {�r&
rP l r\ T PHONE
LOCATION: Assessor's fviap Number
PARCEL_
LOT (S)
SUBDIVISION
j .,� ... stgi( 'f (ooj) ST. NUMBER �f
STREET �I/ 2 .��' It �? �
USE O N LY t**t***r***************************
RECOMMENDATIONS OF TOWN AGENTS:
CONSERVATION ADMINISTRATOR DATE APPROVED
DATE REJECTED
COMMENTS
DATE APPROVED
TOWN PLANNER DATE REJECTED
COMMENTS
DATE APPROVED
FOOD INSPECTOR-HEALTH DATE REJECTED
SEP c"' SPE i -HEALTH DATE APPROVED -
-- DATE REJECTED
COMMENTS
PUBLIC WORKS - SEWER/WA T ER CONNECTIONS
ONS
DRIVEWAY PERMIT
_ r
FIRE DETARTIMENT K Qv Evs r
)),r1�r- /�—. Y r?cle h T/b� [J.tf�
L` DATE
RECEiVED BY BUILDING INSPECTOR
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