HomeMy WebLinkAboutMiscellaneous - 67 HICKORY HILL ROAD 4/30/2018 67 HICKORY HILL ROAD
J f 210/061.0-0065-0000.0 ROAD
FORM U
TOWN OF NORTH ANDOVER
LUT RELEASE FORM
i
SUBDIVISION 1 , ' ✓ l
ASSESSORS MAP
SUBDIVISION LOT(S) O�
PERMANENT ADDRESS ASS NED BY D.P.W.
STREET
APPLICANT 1 \6(1(�.�,tS T_7r,�0�� PliUNE _-ILS -1 6-7
DATE OF APPLICATION
TOWN USE BELOW Tfi1S LINE
PLANNIN BOARD
llA'1'E APPROVED
TOWN LANNER DA'Z'E REJECTED
CONSERVATION COMMISSION
DATE APPROVEDr 4/
CONSERVATION--'ADMIN.- V DATE REJECTED
BOARD OF HEALTH
DATE APPROVE11)
`HEA UtANI AR 119 ��� ����`��� llA'1'E REJECTEDoc- 'Al
DEPARTMENT OF PUBLIC WORKS
DRIVEWAY PERMIT � a� -
SEWER/WATER CONNECTIONS (� M S ,,' Z `r j ttl
FIRE DEPT. e-C n I�l? �f C ��
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RECEIVED BY BUILDING INSPECTION
DATE
This form shall be signed by the agents of: the Planning and 1len1th Boards,
the Conservation Commission prior to the i.,suanc:e of any bul.ldinf; permits
for the subject lot. This form shall not releive the apl,licant from the
compliance of any applicable Town requirement or 13}•Iaw.