HomeMy WebLinkAboutMiscellaneous - 330 CAMPBELL ROAD 4/30/2018N
Ooo
O1 n
b
b ai
Om
N T
0 0
o
w
J
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 or requirements. F
*****************************APPLICANT FILLS OUT THIS SECTION
PHONE
APPLICANT S �"
LOCATION: Assessor's Map Number--Z4L
PARCEL
LOT (S)
SUBDIVISION
. � 0� ST. NUMBER �36
STREET
*************************OFF 1C !A L USE 0 N LY*****************************
�20 �&q 014(6/0 PF-,�V- o,
RECOMMENDATIONS OF TOWN AGENTS: S}rU c� r� — �A,,, , �y �� �,,,,,-
CONSERVATION ADMINISTRATOR DATE APPROVED 6 Z'} G.
r DATE REJECTED
COMMENTS
TOWN PLANNER
COMMENTS
FOOD INSPECTOR -HEALTH
WvS-E �I-C IN�I^CTOR-HEALTH
COMMENTS
DATE APPROVED
DATE REJECTED.
DATE APPROVED
DATE REJECTED__
DATE APPROVED
DATE REJECTED
C, z
�G 2
I PUBLIC WORKS - SEWERlWATER CONNECTIONS
DRIVEWAY PERMIT
FIRE DEPARTMENT
RECEIVED BY BUILDING INSPECTOR
Revised 9197 jm
DATE
Daniel A, Ciard
P� Ceneral Contracting
i30A Appleton St.
�'o. Andover, :YLA 01845
(978) 686-7653
0\
S; e-ve. me-62-e``��
M14-
�N
�— ApplUy - 410 �T %
yil --
a.�o _
.I
•' NC 11'1 �1�115 �V09. �' o. OZ I
MSH �a 103.03 - r
S3�I�b�9'Z
TON :101
1
v
4L
N
yil --
a.�o _
.I
•' NC 11'1 �1�115 �V09. �' o. OZ I
MSH �a 103.03 - r
S3�I�b�9'Z
TON :101
W
A
O
A
�
o
n.
p
D
O
cn
I
�
O
-s
Q
O
er
1
3
W