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HomeMy WebLinkAbout2006 Sep 19 - Sign Off Transmittal, Plan - 12x16 Addition on Existing Deck -
OWN OF YARMOUTII
, ,:i..tvit ; - /HEALTH DEPARTMENT
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PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET
To be completed by Applicant: . •
1 Building Site Location: 2 0.,1 1 n-tetri Cl-r . Map No.:/25 Lot No.: 11495
1
7
Proposed'Improvement: 12' )(101 oddybOn on Exi -hy9
Applicant: (iQ1)10_, itIA/1,5 6b1 ICW.S. Inc . Tel. No.:fa•,21:44 6332.
Address: Q ti N.) VillfiXt,di.4.fri 5.Nail 6 . pia Date Filed:
' **Ifyou would like e-mail notification of sign off please provide e-mail address: cibc..4a.c.tc, 0 comcc,s±, j' Q_.+
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Owner Name: (2). 511L)ILK...
(1.,1)t--
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Owner Address: 2,5 CA i hip() di , Owner Tel No.:
RESIDENTIAL AND/OR COMMERCIAL BUILDING ' .---
HEALTH DEPARTMENT: Determines Compliance to State and Town Regulations; i.e., Requirements
For Septage DisposaLand other Public Health Activities.
Please submit four(4) 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 reqstired for decks, sheds, windows, roofing;
(3.) If necessaryrTitle 5 application signed KY licensed installer
with fee.
-r-71:141.EVIEWED BY: /
,--' DATE: 7// 0 6
1 PLEASE NOTE
COMMENTS/CONDITIONS:
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