HomeMy WebLinkAboutMiscellaneous - 890 JOHNSON STREET 7/15/1998 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 or requirements,
*****************************APPLICANT FILLS OUT THIS SECTION***********************
APPLICANT L PHONE 6/912-
LOCATION: Assessor's Map Number o PARCEL
SUBDIVISION LOT (S)
STREET "g V'^ 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
SEPTIC INSPCfOR-HEALTH YN DATE APPROVED
DATE REJECTED
COMMENTS
PUBLIC WORKS -SEWER/WATER CONNECTIONS
DRIVEWAY PERMIT
FIRE DEPARTMENT
RECEIVED BY BUILDING INSPECTOR DATE