HomeMy WebLinkAboutMiscellaneous - 14 PURITAN AVENUE 10/28/1997 FORM U - LOT RELEASE FORD
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: ) (�• �'✓��/��i� --�i�� Phone c�SJ-vim J
LOCATION: Assessor' s Map Number Parcel
subdivision Lot(s) l�
Street ! &f' c7Il 6-e%. St. Number
***************** ** **Official Use Only************************
RECO D, OV TOWN AGENTS:
-� Date Approved _
Conservation dministra or Date Rejected
Comments
�CP-) Cn( Date Approved
town Planner °" Date Rejected
Comments
Date Approved
Food /Inspector-Health Date Rejected /
�tl 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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