HomeMy WebLinkAboutMiscellaneous - 2189 TURNPIKE STREET 11/5/1992 FORM U - LOT RELEASE FORM
INSTRUCTIONS: This form is used to verify that all necessary
approvals/permits from Boards and Departments having jurisdiction
have been obtained. This does not relieve the applicant and/or
landowner from compliance with any applicable local or state law,
regulations or requirements.
************/*�***Applicant fills out this section*****************
APPLICANT: Phone C V !Z .S 310
LOCATION: Assessor' s Map Number 161 <3 C Parcel 21I—IaZ a/al'7
Subdivision o.i Lots)
St. Number /
************************Of:ticial Use Only************************
RECOMMENDATIONS OF TOWN AGENTS:
Date Approved
Conservation Administrator Date Rejected
Comments l./
Date Approved h
Town Planner Date Rejected
Comments
Date Approved /G
Health Agent Date Rejected
Comments
Public Works -sewer/water connections
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driveway permit 6,t,1t cz,,,a�, Fl j3KC
Fire Department
Received by Building Inspector Date