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HomeMy WebLinkAboutMiscellaneous - 41 NORTH CROSS ROAD 11/8/2002 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 '�V /// ~, �!� 50/ PHONE-% 7, �'�� LOCATION: Assessor's Map Number PARCEL SUBDIVISION LOT(S) 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 INSPECTOR-HEALTH DATE APPROVED �/71 DATE REJECTED / COMMENTS C_,Qf-hC1 T r h 7") ✓fi e ry`�e_ _y)C) PUBLIC WORKS-SEWER/WATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT RECEIVED BY BUILDING INSPECTOR DATE Revised 9\97 jm 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 A.�1�/r'' J11C 1SeJ/y PHONE -��� _ S 3 -a 6r� LOCATION: Assessor's Map Number PARCEL SUBDIVISION LOT(S) STREET L// CJj G'-Ss $ 7- IV4 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 INSPECTOR=HEALTH— DATE APPROVED c COMMENTS I B S t nl e .J �-<<' S f �h ���f• PUBLIC WORKS-SEWER/WATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT RECEIVED BY BUILDING INSPECTOR DATE Revised 9\97 jm FORM U - LOT RELEASE FORM tc- INSTRUCTIONS: This form is used to verify that all necessary approvals/permits r C1 artments haven from Boards and Departments g 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 V��J/JckSey V PHONE LOCATION: Assessor's Map Number PARCEL SUBDIVISION A 1,1 r 14 LOT(S) STREET ��� CJj(sS .S r" /V,11 ST. NUMBER :�4/ ************************************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 INSPECTOR-HEALTH DATE APPROVED DATE REJECTED G b` COMMENTS L� S I ��� r`z � �dJ 4° uN3 t Ly C ��4 tf i� r (�/) (.i p J PUBLIC WORKS -SEWER/WATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT RECEIVED BY BUILDING INSPECTOR DATE Revised 9\97 jm f t I w (1 y „ti�. '✓} f '. � : jai ros . 1 `h f I 1 �fy; 1 � 1 f i 9 f^, k. . m, m d A q r r