HomeMy WebLinkAboutMiscellaneous - 16 HALIFAX STREET 4/30/2018 16 HALIFAX STREET
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FORM U - IAT 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*****************
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APPLICANT: % /,�its �1 Phone
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LOCATION: Assessor' s Map Number Parcel
Subdivision Lot (s) _7�
Street �' � -% `� \j St. Number
************************Official Use Only************************
RECOMMENDATIONS OF TOWN AGENTS:
Date Approved
Conservation Administrator Date Rejected
Comments -2tU,*�4 (0rjfrW8
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14-16�p'�_$' Date Approved
Town Planner Date Rejected
CH-
Comments
Date Approved
Food Inspector-health Date Rejected
ADate Approved
Sep is Inspector-Health Date Rejected
Comments
Public Wcrks - sewer/water connections
- driveway permit
Fire Department
Received by Building Inspector Date
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