HomeMy WebLinkAboutMiscellaneous - 60 LONG PASTURE ROAD 4/12/2000 FORM U - LOT RELEASE F®RM
INS T PCUCTIONS: This form is used to verify that all nec--scary approvals/permits from,
Boards and Departments having jurisdiction have been Obtained. This'does not relieve
the applicant and/or landowner from compliancy with any applicable or.requirernents.
APPLICANT FILLS OUT THIS SECTICN�"'""""
APPLIC„NT lJ\4�
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LOCATION: Assessors Mao dumber II '' FARCE_
SUEDIVISION LOT (S)
STREET ii 6a U,,1Q 'VG �x ST. NUiYIEE:R
OFFICIAL USE ONLY'
FRF=CCMN1EN0ATICNS OF TOWN AGENTS: O
CONSEIRVATION ADMINISTRATOR DATE APPROVED 41 1 00
DATE JREJECTED {
COMMENTS l�11f ✓/���-L e•. �11T- `— C IUS��fi -, bsr�)
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TOW CANNER DATE APPROVED
DATE REJECTED
COMMENTS
FOOD INSPECTOR-HEALTH DATEAPPROVED
DATE REJECTED
C S ECTOR-HEALTH DATE APPROVED
1 DATE REJECTED
COMMENTS
PUBLIC WGRKS -SENERMATER CONNECTIONS
DRIVE-NAY PERMIT
FIRE DEPARTMENT
RECEIVED EY EUILDING ii ISPECTCR DAT-
Revised 919;Im
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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.
,.............t............/..................■.............................■
APPLICANT toC, ', � ! PHONE
ASSESSORS MAP NUMBER LOT NUMBER
SUBDIVISION ���° / S �- S LOT NUMBER
STREET AOII f P�s STREET NUMBER �?�
OFFICIAL USE ONLY
RECONIlvIENDATIONS N TOWN AGENTS
DATE APPROVED
CONSERVATION ADMINISTRATOR
((( DATE REJECTED {
COMMENTS
DATE APPROVED
TOWN PLANNER
DATE REJECTED
COMMENTS
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j
i
DATE APPROVED
FOOD INSPECTOR- TH DATE REJECTED
- ' DATE APPROVED
SE PTI IN&fCTOR-HEALTH -
(� DATE REJECTED
COMMENTS a >: -
PUBLIC WORKS-SEWER/WATER CONNECTIONS
DRIVEWAY PERMIT
DATE APPROVED
FIRE DEPARTMENT
DATE REJECTED
COMMENTS
i
RECEIVED BY BUILDING INSPECTOR DATE
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