HomeMy WebLinkAboutMiscellaneous - 1423 SALEM STREET 4/30/2018 (81) BOARD OF HEALTH
NORTH ANDOVER, MA 01845
978-688-9540
APPLICATION FOR DISPOSAL WORKS CONSTRUCTION PERMIT
DATE:__ CURRENT INSTALLER'S LICENSE#
LOCATION: L
LICENSED INSTAL : v
D L
SIGNATURE: 4-?TELEP ONE#
CHECK ONE:
REPAIR: NEW CONSTRUCTION:
IF NEW CONSTUCTION, PLEASE ATTACH FOUNDATION AS-BUILT.
Administrative Use Only
160.00 Fee Attached? Yes t1 No
Project Manager Ob. Yes No
i
Foundation As-Built? Yes No
Floor Plans?
Yes No
Approval le �--� Date: � (J