HomeMy WebLinkAboutBuilding Permit #Exception - 276 RALEIGH TAVERN LANE 5/1/2018 r
NORTH
BUILDING PERMIT 14 �°*q+O
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APPLICATION FOR PLAN EXAMINATION -
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t NO: Date Received �'°°R,T:°
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IMPORTANT:Applicant must complete all items on this page
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OF IMPROVEMENT f-PROPOSED USE
sidential Non- Residential
hew Building One family
addition Two or more family In
k1teration No. of units: Commercial
Zepair, replacement Assessory Bldg Others:
)emolition Other
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DESCRIPTION OF WORK TO BE PREFORMED:
Identification Please Type or Print Clearly)
'NER: Name: Phone:
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CHITECT/ENGINEER Phone:
Dress: Reg. No.
FEE SCHEDULE:BULDING PERMIT:$42.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F.
tal Project Cost: $ _0 �'�O FEE: $ �� d
eck No.: Receipt No.:
ITE: Persons contracting with unregistered contractors do not have access to the guaranty fund
satire c�f'AaenOwner �y` .rt Sigr atl�Te'of contractor '1 = .
Plans Submitted Plans Waived Certified Plot Plan Stamped Plans
TYPE OF SEWERAGE DISPOSAL
Public Sewer
Tanning/Massage/Body Art Swimming Pools
Well Tobacco Sales
Food Packaging/Sales
Private(septi, ,etc. Permanent Dumpster on Site
THE FOLLOWING SECTIONS FOR OFFICE USE ONLY
INTERDEPARTMENTAL SIGN OFF - U FORM
DATE REJECTED DATE APPROVED
PLANNING & DEVELOPMENT
COMMENTS '
DATE REJECTED DATE APPROVED
CONSERVATION
COMMENTS
DATE REJECTED DAT P ROVED
HEALTH 1 ��1
COMMENTS
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Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes
Planning Board Decision: Comments
Conservation Decision: Comments
Water & Sewer Connection/ Driveway Permit
Located at 384 Osgood Street
SIREEPARTME°NT ;Tem `?Dum s#er on si#e des` n�,
Located at"124�11ain Street
fireepax�etat s�gnature�cate
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