HomeMy WebLinkAboutMiscellaneous - 127 HICKORY HILL ROAD 4/30/2018 127 HICKORY HILL ROAD
2101062._ 0 000.0 ROAD -
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Mu•l U
TOWN of NORTH AI11)UVER
LOT RELEASE FORM
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SUBDIVISION
~?; ASSESSORS MAP
SUBDIVISION LOT(S)
P)rRMA 'NT ADDRESS SI LU I3Y U.1'.W.
STREET l (-v
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APPLICANT �1�a Mac; `�. / �0-(Lkt C ` PHONE
DATE OF .APPLICATION
TOWN USE BELOW THIS LINE
PLANNING BOARD
DATE APPROVED
TO PLANNER DATE REJECTED
CONSERVATION COMMIS ION
UAT • APPROVED /0//
CONSERVATION ADMIN. 0 REJECTED
BOARD OF HEALTH
DATE APPROVED
HEA T S&ITTcW DA'Z'E REJL•'CTED
%DEPARTMENT OF PUBLIC WORKS
DRIVEWAY PERPIIT
SEWER/WATER CONNECTIONS
FIRE DEPT.
RECEIVED BY BUILDING INSPECTION
DATE
This form shall be signed by the agents of the Planning and Health Boards,
the Conservation Commission prior to the issuance of any building perml.ts
For the subject lot. _ This form shall riot releive the applicant from the