HomeMy WebLinkAboutMiscellaneous - Lot 1 Ingalls Street (3)FOR11 U
TOWN OF NORTH ANDOVER
LOT RELEASE FUM
SUBDIVISION
ASSESSORS MAP S D
SUBDIVISION LOT(S)
PERMANENT ADDRESS (ASSIGNED BY D.
Y' r
STREET
APPLICANT PHONE j -d – y `78 J W
DATE OF APPLICATION
PLANNING BOARD
OWN PLANNER
CONSERVATION COTiri SS/IO
ONSERVATION ADHIN.
BOARD OF HEALTH
HEALTH SANITARIAN
TOWN USE BELOW THIS LINE
DATE APPROVED
DATE REJECTED
DATE APPROVED
DATE REJECTED
DATE APPROVED n
DATE REJECTED
DZPARTI•iENT OF PUBLIC WORKS
- —
f
DRIVEWAY PER1•1IT �✓ C � :�,, i–
jo',"EWER/WATER CON ECTiONS
:IRE DEFT.
RECEIVED BY BUILDING INSPECTION
DATE
this form shall be signed by the agents of the Planning and Health boards,
the Conservation Commission prior to the issuance of any building permits
cor the subject lot. This form shall not releive the applicant from the
ompliance of any applicable Town requirement or Bylaw.