HomeMy WebLinkAboutMiscellaneous - 20 ENGLISH CIRCLE 4/23/1991 FOItPI u
TOWN Of NORTH ANDOVER
LOT RELEASE FOR1
SUBDIVISION
ASSESSORS MAP
SUBDIVISION LOT(S)
PERMANENT ADDRESS ASSIGNED BY U. Y.W.
STREET xy .S 77
APPLICANT ,eM {� � �i�3 ��• PtruNE 6 '- s
DATE OF APPLICATION
'1'UWN USE BELOW '1'1115 LLNE
PLANNING BOARD
DAII. AI'PROV1.i)
TOWN PLANNER DALE REJECTED
CONSERVATION COMMISSION
DArE nllI�0vE0 '
CONSERVATION ADMIN. DATE REJECTED
BOARD OF L' i
DA'1'I; A I'll t0V1;*1)
H '111 SA I'' i DA 111 ItEJ ECTI,D
DEPARTMENT OF PUBLIC WORKS
DRIVEWAY PERMIT
SEWER/WATER CONNECTIONS
FIRE DEPT.
RECEIVED BY BUILDING INSPECTION
DALE
This form shall be signed by the agents of the I'Irunilrrl; and Ii; r; lth Ho ;rrin ,
the Conservation Conunission prior to the issuance of any bu tl.d hm, prat m l t�;
for the subject lot. This form shall not reteive the applicant from the
compliance of any applicable 'Town requirement or Bylaw.
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: -Phone 7�
LOCATION: Assessor' s Map Number Parcel
Subdivision Lot(s)
Street r Std Number r
Use Only************************
RECOMMENDATIONS OF TOWN AGENTS
Date Aonroved
Conservation Administrator Date Rejected
Comments
Date Approved
Town Planner Date Rejected
Comments
Date Approved
Food Ins ctor-Health Date Rejected
Date Approved
S ` tic nspector®Health Date Rejected
Comments
Public Works - sewer/water connections
- driveway permit
Fire Department
Received by Building Inspector Date