HomeMy WebLinkAboutMiscellaneous - 492 SALEM STREET 9/6/2000 FORM - U - LOT RELEASE FORM
INSTRUCTIONS: This form is used to verify that all-necessary approval/permits from
Boards and Departments having jurisdiction have been obtained. This does not relieve the
applicant and or landowner from compliance with any applicable requirements.
�........... .............................................................
APPLIC e �` ,� PHONE
ASSESSORS MAP NUMBER n LOT NUMBER 6)66(—
SUBDIVISION LOT NUMBER
ST n STREET NUMBER �Z,9-2-
........................... Ono n s o o n USE ONLY °`....... n:. .. .......
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REC0MAIENDATIONS OF TOWN AGENTS
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1 -r� lr � 32✓ `;' DATE APPROVED Y (110
CONSERVATION ADMINISTRATOR
DATE REJECTED
COMMENTS
DATE APPROVED
V TOWN PLANNER
DATE REJECTED
COIvffVRENT S
DATE APPROVED
FOOD INSPECTOR-HEALTV DATE REJECTED
✓ SEPTIC INSPECTOR-HEALTH DATE APPROVED / l
DATE REJECTED
COMMENTS CQ'Ic) rn&,)-0,)
PUBLIC WORKS-SEWER/WATER CONNECTIONS
DRIVEWAY PERMIT
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DATE APPROVED
FIRE DEPARTIv1ENT
DATE REJECTED
COT\M ENTS
RECEIVED BY BUILDING INSPECTOR DATE
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