HomeMy WebLinkAbout2006 Jun 19 - Sign Off Transmittal, Plan - Replace Rotting Deck 1' yr`w
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4o;` TOWN OF YARMOUTH
' �'i HEALTH DEPARTMENT
N SI .i'
PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET
To be completed by Applicant
Building Site Location: 3 o Tv r±/€ Cpm $Z.d Map No.:Sc?' Lot No.: I I
,Proposed Improvement: Pl&.t 1"a i- ,i7) deck Gaemf S(2 .. 4- Ldcu-t; cs-ki .20 )4 t x
t
Applicant: Tel. No.: 56s-3 y 9^3 7 2l9
Address: '3 6"I wr.s4L, C c y,p P so , )/ ,, Date Filed: (//,7 I6 o
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**If you would like e-mail notification of sign off,please provide e-mail address:
Owner Name:
Owner Address: 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 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 required for decks, sheds, windows, roofing;
(3.) If necessary, Title 5 application signed by licensed installer
with fee.
REVIEWED BY: DATE: C 1I `'l C
l , PLEASE NOTE
COMMENTS/CONDITIONS:
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N. 1
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APPLICANT.' JOAN C. HECKEL TOWN' YARMOUTH
-_ -_- -40 Atl r^
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LOT 3
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LOT 2 / / / / / y. zv Q'�,c ;. L =d
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