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HomeMy WebLinkAbout2020 Jan 21 - Sign Off Transmittal, Floor Plan - Finish Basement otN- o.,'�ki. TOWN OF YARMOUI ° HEALTH DEPARTM T `' `� . PERMIT APPLICATION SIGN OFF _ ANSMITTAL SHEET To be completed by Applicant: Building Site Location: , . F - '/' t b'd/1am.. 1 . \- . (►,1 1 1Id Proposed Improvement:"'' CA . .i1 A J ahv Applicant110 e yam,., (A-D_1,3--P:40 C &- l � --1S-7ES-7E � Tel. Noll Address: \a,- e( )-t Lo !/l ..)/ tr MD(if-i \ Date Filed: 1 ),D) 1 **If you would like e-mail notification of sign off,pease provide e-mail address: fCh I e. t 1 -J--g t XJCt Owner Name: Pa-hr I Ci CC..- , aaleDe rr- Owner Address: \-4 ./.►./ " /i. Owner Tel. No.a lc) 1?- 1 0 ..., A - IP- Nian\-/to , RE' IDENTI 'L AND/OR COMMERCIAL BUILDING HEALTH DEPARTMENT,D� �rarl Compliance to State and Town Regulations; i.e., Requirements ror.,S� tage 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 insilaller �"" with fee. 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