HomeMy WebLinkAboutMiscellaneous - 41 CHERISE CIRCLE 9/6/1994 FORM U T 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: �'c� C, L/-� T� C1 Phone
LOCATION: Assessor' s Map Number Parcel
Subdivision "i �� � Lot (s)
Street olewl St. Number
************************Official Use Only************************
RECO�ITNDATIONS OF TOWN AGENTS: Date Approved 4/_z
Conservation Administrator Date Rejected
Comments
Date Approved
Town Planner Date Rejected
Comments
Date Approved
Food Inspector-Health Date Rejected
4, J tlJ Date Approved
Septic Inspector-Health Date Rejected
Comments
Public Works - sewer/water connections
- driveway permit
Fire Department
Received by Building Inspector Date
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