HomeMy WebLinkAboutMiscellaneous - 51 LYONS WAY 4/30/2018 - -I ��
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FORM - U - LOT RELEASE FORM
INSTRUCTIONS: This form is used to verify that all-necessary approval/permits from
Boards and Departments having jurisdiction have been obtained.This does not relieve the
applicant and or landowner from compliance with any applicable requirements.
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APPLICANT &e-Sl U-9 ,v. �'�'P PHONE 5 5`7~s ` v 11
ASSESSORS MAP NUMBER U LOT NUMBER
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SUBDIVISION S W LOT NUMBER `7
STREET Y S Zvi STREET NUMBER
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OFFICIAL USE ONLY
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RECOMMENDATIONS OF TOWN AGENTS
on
DATE APPROVED
CONSERVATION ADMINISTRATOR
DATE REJECTED
CON%4E'NTS
DATE APPROVED
TOWN PLANNER
DATE REJECTED
CONR ETTTS
DATE APPROVED -
FOOD INSPECTOR-HEALTH DATE REJECTED l
DATE APPROVED j4�
SEPTIC INSPECTOR-HEALTH
DATE REJECTED
CoWaNIs
PUBLIC WORKS—SEWER/WATER CONNECTIONS
DRIVEWAY PERMIT
a
DATE APPROVED
FIRE DEPARTNvIENT
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DATE REJECTED
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CONDAENTS
RECEIVED BY BUILDING INSPECTOR DATE
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