HomeMy WebLinkAboutMiscellaneous - 10 CHERISE CIRCLE 9/6/1994 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 section*****************
APPLICANT: cCry -_s - CUY\.J � Phone
LOCATION: Assessor's Map Number Parcel
Subdivision Lot (s)
Street C4 ella l.J -e AZ/_1\_U C St. Number
************************Official Use only************************
RECOMMENDATIONS OF TOWN AGENTS:
Date Approved
Conservation Administrator Date Rejected
Comments
Date Approved
Town Planner Date Rejected
Comments
Date Approved
Food Inspector-Health Date Rejected
Date Approved
Septic Inspector-Health Date Rejected
Comments
Public Works - sewer/water connection
- driveway permit
Fire Department
Received by Building Inspector Date
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BUFFER LINE
LOT J
AREA-21780 S.F.
28.9
37.7'
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36.7'
93.5'
I CERTIFY THAT PRIMARY STRUCTURE
FOUNDATION LOCATION PLAN THE HORIZONTALT SETBACK REQUIREMENTS OF SHOWN LOCALRMS TO
APPLICABLE ZONING BY—LAWS IN EFFECT WHEN CONSTRUCTED.
(THIS CERTIFICATION DOES NOT CONSIDER ANY OTHER
SUCH AS
CLIENT:
JPD DEVELOPMENT ORDERS RESTRICTIONS
CONDI TI ONS,ETC.)NANTS,WETLANDS,EASEMENTS,
THIS DRAWING SHALL NOT BE USED BY THE CLIENT FOR ANY
THIS CERTIFICATION IS MADE AND LIMITED PURPOSE OTHER THAN THAT OUTLINED ABOVE,EXCEPT WITH THE
WRITTEN PERMISSION OF CHRISTIANSEN & SERGI INC.
TO THE ABOVE CLIENT. FURTHERMORE THIS DRAWING IS THE COPYRIGHTED PROPERTY
OF CHRISTIANSEN & SERGI INC. AND ANY UNAUTHORIZED USE
IS PROHIBITED.CHRISTIANSEN & SERGI TAKES NO RESPONSIBILITY
FOR THE UNAUTHORIZED USE OF THIS DRAWING OR ANY INFOR-
MATION CONTAINED HEREON, SHOWN
LOCATION: NORTH ANDOVER,MA. IS NOT LOCATED INDATFLOOD HAZARDRZONE ASRSHOWN ON FEMA
FLOOD INSURANCE RATE MAP.
COMMUNITY NO.: 250098 0005C DATE:6/2/93
SCALE: I" ® 40' DATE: SEPT.2 9, 1995 �p�lh or
ELF
'E GI L4
C'1I RI S TIA NS'EN I� SERGI ,
PROFESSIONAL ENGINEERS
0, LAND SURVEYORS �s ER
160 SUMMER Sr. HAVERHILL,MA. OIB30 TEL. 508-373-0310 :ry lAtbCy",�'
O 1995 BY CHRISTIANSEN & SERGI INC.
DR G No. 93067016
Form No.3 1
Town of North Andover, Massachusetts
NORTH BOARD OF HEALTH 9
19 • S�
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DISPOSAL WORKS CONSTRUCTION PERMIT
,SSACHUSES
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i
Applicant 7-,lm TELEPHONE
NAME ADDRESS f
Site Location
Permission is hereby granted to Construct ( or Repair ( ) an Individual Soil Absorption
: Sewage Disposal System as shown on the Design Approval S.S. No. za
' CAF AIRMAN, B A D OF HEALTH
D.W.C. No. 776
Fee -
: