HomeMy WebLinkAboutPlanning Permit # 4/8/1996 ( 63)
FORM U - VERIFICATION 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.
****************Applica fills out this section*****************
APPLICANT: Phone (or z.
LOCATION: Assessor' s Map Number l9 Parcel
Subdivision d' Lot(s)
Street r`" St. Number
************************Official Use only************************
REC NDATIONN OF TOWN AGENTS
Date Approved
s�nservat� on Administrator Date Rejected
Comments
Date Approved
Town Planner Date Rejected
Comments
Date Approved
Food Inspector-Health Date Rejected
Date Approved
Septic Inspector-Health Date Rejected
Comments
Public Works - sewer/water connections
- driveway permit
k-T-ire Department
Received by Building Inspector Date