HomeMy WebLinkAbout2019 Jul 17 - Sign Off Transmittal, Plan - Covered Front Porch Rdt-f 4k,,, TOWN OF YARMOUTH
st c HEALTH DEPARTMENT
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,,, ,.-` PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET
To be completed by Applicant:
Building Site Location: &ii, ( o'hit ea-, t (A, _i,,; -
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Proposed Improvement:
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Applicant; ARK 1)t 6 A t„} �, f I i ;., O
PP � ��.,�� . �� -��� ��,�-� �."�::. Tel. No.: �? ,� :i3
Address: , )(1-170L, " d to r ' A. Date Filed:? /7- 17
**If you would like e-mail notification ofsign off please provide e-mail address:
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Owner Name: dry`&ii I)1(c !
Owner Address: S 6 vvt Z G> c-/ ; +‘:),/,,,y; (ice„,c. Lc_ Owner Tel. No.:"ra - y `, ,,i6.,-,??
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.
REVIEWED BY: 0 , DATE: 7- 17
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