HomeMy WebLinkAboutMiscellaneous - 300 SALEM STREET 4/30/2018 (2) 300 SALEM STREET
210/037.D-0043-0000.0
'I
�I
�I
I;
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 local or state law,
regulations or requirements.
I
****************Applicant fills out this section*****************
APPLICANT: Ca"►-z� �wCiL (-c)S 6ec) Phone
LOCATION: Assessor's Map Number 4T? +O Parcel Debt/
Subdivision Lot(s)
Street !�-'/fir S% St. Number 3co
cial Use Only************************
�R-{ECCOMMENDATIONS OF TOWN AGENTS:
` Date Approved
Conservation Administrator Date Rejected
Comments
%X-- Date Approved " Fy-0 z
Town Planner Date Rejected
Comments
Date Approved
Health Agent Date Rejected
Comments
Public Works - sewer/water* connections � &2, �a
- driveway permit T/.�, %u��� h 1 ,���r r-�f c�/'�?l,, �� '5;�
Fire Department
U J
Received by Building Inspector Date
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 local or state law,
regulations or requirements.
****************Applicant fills out this section*****************
APPLICANT:
Phone _
LOCATION: Assessor's Map Number Parcel
Subdivision
Lot(s)
Street L4 ,C�/�/ % St. Number 360
************************Official Use Only************************
RECOMMENDATIONS OF TOWN AGENTS:
Conservation Administrator Date Approved
Date Rejected
Comments
Town Planner Date Approved
Date Rejected
Comments
Date Approved /8
Health Agent Date Rejected
Comments
Public Works - sewer/water
connections
driveway permit
Fire Department
Received by Building Inspector
Date