HomeMy WebLinkAbout2017 Mar 27 - Sign Off Transmittal Sheet, Plans - Screened Porch o!�.�Yq� TOWN OF YARMOUTH �
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�; �-;°� HEALTH DEPARTMENT
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ti�r PE IT APP.�'�ATION SIGN OFF TRANSMITTAL SHEET
To be completed by Applicant:
Building Site Location: --,�' eC..s`._ �r� . ,s- v II
Proposed Improvement: C��,r^r-�• r-�.�c�. (��c�l. / � ' �. ;� `
Applicant: � Tel. No.:15 a� ���' ��5�
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Address: r � Date Filed: /
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**If you would like e-mail notafacation of sign of�j;please provide e-mail address:
Owner Name: � -
Owner Address: -� ✓� �' ,i wner Tel.No.:��/ -��-�.d�j`7
..................................................................................................................................................................................................................................................................................................................................................................
RESIDENTIAL AND/OR COMMERCIAL BUILDING
HEALTH DEPARTMENT: Determines Compliance to State and Town Regulations; i.e., Requirements
For Septage Disposal and other Public Health Activities.
Please submit three (3) copies of plans, to include:
(1.) Site Plan showing existing buildings, water line location,
and septic system location;
(2.) Floor plan labeling ALL rooms within building
(all existing and proposed) —
Note:Floor plans not required for decks,sheds, windows, roofing;
(3.) If necessary, Title 5 application signed by licensed installer
with fee.
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REVIEWED BY: ` DATE: 3- a 7— � <<
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