HomeMy WebLinkAboutMiscellaneous - 14 WINDKIST FARM ROAD 6/2/1997 FORM U - VERIFICATION 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: ��/G'C���5 11- � Z G Phone
-LOCATION: Assessor' s Map Number Parcel
Subdivision �J �C . /s !� f�2/y/ Lot (s) _
Street ,(2 St. Number
************************0 ficial Use Only************************
RECOMMENDATIO S OF GENTS:
p
Date Approved
Conservation Administrator Data Rejected _
Comments
Date Approved
own Planner Date. Rejected
Comments C2h�G
Date Approved
Food Inspector-Health Date Rejected
Date Approved
Septic Inspector-Health Date Rejected
Comments
Public Works - sewer/water connections 7, ���'
- driveway permit
re Department Jw,14�" /�
Received by Building Inspector Date