HomeMy WebLinkAbout2013 Mar 08 - Sign Off Transmittal - Deckpt:'Y'g1�
TOWN OF YARMOUTH
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HEALTH DEPARTMENT
PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET
To be completed by Applicant:
Building Site Location: 7/_�' /)' ')c
Proposed Improvement: "I'a �'/j
Applicant: ,4 7-Yo 73 ` e
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**If you would like e-mail notification of sign off, please provide e-mail address:
Owner Name:
Owner Address: i0yon'r "' " ` `� �lP'�'' � `� � Owner Tel. No
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:
(L) 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:
PE/EASE NOTE
COMMENTS/CONDITIONS:
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• NEW TIEfX AREA 547 SF
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