HomeMy WebLinkAboutMiscellaneous - Rocky Brook Road (6)FORM U - WT RELASE 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: A=ssessor's Man
Nuimber � Parcel
Subdivision Lot(s)
Street c. St. Nu-icer
Use Only************************
RECOMMENDATIONS OF TOWN AGENTS:
Date An-c-oved
cons e_ .ration Ad-;inistrazor Daze Rejected
Cc er;t-
Town Planner
Comments
FOGA :nszec,:=-:iealth
Senz_c inspec. cr- eal�-^
CoaR.0 e:
'rVcr:a - sewer/'water connections
- driveway_, per: -it
Fire Demart-ent
Date Approved
Date Rejected
Daze Approve,
Date Refl ect=d
Date Approved;
Date Reject__
Received by Building Ins=ector Date