HomeMy WebLinkAboutConstruction Approval Worksheet - 04.30.1992 - Miscellaneous - 68 TUCKER FARM ROAD 11/20/2020 1 t
MAP #. _-----_ — LOT #_.._�_..........._..._.........
PARCEL # --------------- STREET_- '.
CONSTRUCTION APPROVAL
HAS PLAN REVIEW FEE BEEN PAID? / YES NU
PLAN APPROVAL: DATE Of ------ APP. BY ............ .....
DESIGNER: 2esS'6�� -__- PLAN DAfE_._.._._ IZ--10
CONDITIONS_--7t 194Qs
f -s ��At�C�fJ '� LJ.CI��� Zi
���-. �_._._. --------- -- ----- ---..... _ _- .......___.t.__....__ ._ .
WATER SUPPLY: (:T:OWN WELL
ERMIT DRILLER
WELL P
WELL TESTS: CHEMICAL DA I E APPRUVED,__.._._,_._..__.
BACTERIA I DALE ftPPROVED
BACTERIA II DALE A1='PRUVEU
COMMENTS:
FORM U APPROVAL: APPROVAL I LU I Ut_ YES NU
DATE ISSUED LAY
CONDITIONS:
FINAL APPROVAL:
ALL PERMITS PAID
WELL CONSTRUCTION APPROVAL YES NO
SEPTIC SYSTEM CONSTRUCTION APPROVAL YE5 NO
OTHER YES NU
ANY VARIANCE NEEDED -YES NO
FINAL BOARD OF HEALTH APPROVAL: UA TE: _ ___ _ ___ By: __ _
ZION
IS THE INSTALLER LICENSED? _YES NO
TYPE OF CONSTRUCTION: NEW REPAIR
NEW CONSTRUCTION: CERTIFIED PLOT PLAN REVIEW ( NO
CONDITIONS OF APPROVAL YES NO
(FROM FOR01 U)
ISSUANCE OF DWC PERMIT YES NO
DWC PERMIT NO. 7 INSTALLER: S __
BEGIN INSPECTION C0:
EXCAVATION INSPECTION: NEEDED:___........
-�I�------- - B Y__
PASSED_
CONSTRUCTION INSPECTION: NEEDED:_.__.._._._._........-......................__.......................... _......._..............AS BUILT PLAN SATISFACTORY:
APPROVAL TO BACKF I LL: DATE:
FINAL GRADING APPROVAL: DATE______._._
FINAL CONSTRUCTION APPROVAL: DATE:,.........