HomeMy WebLinkAboutMiscellaneous - Rocky Brook Road (7)i I r
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 local or state law,
regulations or requirements.
****************Applicant fills out this section*****************
APPLICANT: 1L�C'� 1//vS �, �L o�tls �Zrr ctKW -Z�e Phone e
LOCATION: Assessor's Map Number Parcel (5-0
Subdivision ✓ Lot (s)
Street St. Number
************************Official Use Only************************
RECOMMENDATON OF WN GENTS:
Conservation Administrator
Comments
Town Planner
Comments
Food Inspector -Health
pt c nspector-Health
Comments
Public Works --sewer/water connections
- driveway permi. lS,5
Fire Department
Received by Building Inspector
Date Approved
Date Rejected.
Date Approved
Date Rejected
Date Approved
Date Rejected
Date Approved 1Q g
Date Rejected
Date