Loading...
HomeMy WebLinkAboutMiscellaneous - 15 LONG PASTURE ROAD 8/7/1997 a® < CD vi _ =C C y MW O y ® C. n ® n A: ® _'y =-a = y' - a = . ®' N y CD fu CD CD y O y n , CD co ' �J = tq 1 = CD co -4 left c� co ® JY W y.o slogan Cx MEOW c C (73 ® Amy y l _ = m *Coco*Coco _v _ C. y C Q D CA i ca f 'Z Lr cr ;-; C C.= h n CD m `° ® CD i CD v J� �'m ca — : W a co � CO) I C C CD r Q1 .... 0 r'E' N' A CL C3 W Cm y y 3ry' ado; r CD CO of 1 0 � � CD CU co =S O � d-m C Clio CU CD = : �L C rb GO n, 5 n r a x o CD- rD a y 1 �r C d i rn ® gs C =� t° �j CD ® cp co tm CD co co v - y `dt cx + �. ' CA ' p ' { H cn f CD cn CD co o _ y ' CD CD CD CD co CD CD CD CD .. f ��ry,,� : ►. f CA) _ crj TV rc E5 T ' + h z ' it F f t - b ` ® NN¢.., - 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 segtion***************** APPLICANT: , Phone LOCATION: Assessor' s Map Number A) 6 Parcel Subdivisionni,_r, � Lot(s) Street 7CC GCS St. Number ************************Official Use Only************************ RECOMMENDATIONS OF TOWN AGENTS: Conservation Administrator Date Approved Date Rejected Comments Town Planner Date Approved Date Rejected Comments Food Ins ector-Health Date Approved Date Rejected Date Approved 3e s nspecto r-Health Date Rejected Comments i Public Works = sewer/water connections - driveway permit 7 Z 7 KIJ Fire Department Received by Building Inspector Date .. FORM U - LOT RELEASE FORM :- INSTRUCTIONS: This form is used to verity that all nec:.ssary approvals/permits from- Boards and Departments having jurisdiction have been obtained. This dces not relieve the applicant and/er landowner from compliance with any applicable or requirements. AFrLICANT F1LLS OUT THIS S�CT10�1��'`*'"''`�"`"'*�" � aPPUCANT ;��o��l�� Conn (X9 �V)C PHCNE LOCATION: Assessors iMGO Numcer 15 Lncl `"SA-Dcc PARCEL SUEDIVISICN Lof)q puyvc CS�CLk3 LOT (S) _ STREET GJ' c1C\ ST. NUMEER OFr=1C1AL USE ONLY RECOMNIENOATIQNS OF TOWN AGENTS: CONSERVATION ADMINISTRATOR DATE APPROVED i� ) DATE REJECTED COMMEN I TOWN PLANNER DATE APPROVED DATE REJECTED COMMENTS FOOD INSPECTOR-HEALTH DATEAPPROVED _ DATE REJECTED SEPTIC INSPECTOR AF-ALTH DATE APPROVED DATE REJECTED - COMMENTS WORKS SENErPiWATER CONNECTIONS pUELIC NCRKS DR1VE'NAY P RMIT F1FE_DEPARTMENT 6 , RECEIVED EY EUILGING i11\ISPECTCR DATE neviied 5197 im