HomeMy WebLinkAboutMiscellaneous - 101 ROCKY BROOK ROAD 8/4/1998 -- FORM U - LOT RELEASE FORM
INSTRUCTIONS: This form is used to verify that all necessary appr®VaWpermits from
Boards and --partments 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 SECTION
APPLICANT l e PHONE
LOCATION: Assessors Map Number PARCEL
I SUBDIVISION CMG Jc P �3� 4� LOT (S)
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STREET ST. NUMBER
***"""`OFFICIAL USE ONLY
RECOMMENDATIONS OF TOWN AGENTS: '
CONSERVATION ADMINISTRATOR DATE APPROVED
DATE REJECTED
COMMENTS
TOWN PLANNER DATE APPROVED
DATE REJECTED
COMMENTS
FOOD INSPECTOR-HEALTH DATE APPROVED
�— DATE REJECTED
SEP-!IC*SPE&T'O'R-HEALT4 DATE APPROVED
DATE REJECTED _
COMMENTS
PUBLIC WORKS -SEWER/WATER CONNECTIONS
DRIVEWAY PERMIT
FIRE DEPARTMENT
RECEIVED BY BUILDING INSPECTOR DATE
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