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Town of Yarmouth
Conservation Commission
Building Permit Sign-off Application
TO BE FILLED OUT BY APPLICANT:
Building Site Location:___________________________________________________
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Map # _______________________ Lot(s) # _________________________________
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Property Owner:________________________________________________________
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Applicant:_____________________________________________________________
Applicant Address:______________________________________________________
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Telephone: ___________________________________ Date Filed ________________
Proposed Project Description:
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_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
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Plans:_____________________________________________________________
TO BE FILLED OUT BY CONSERVATION ADMINISTRATOR:
Does the Proposed Project Require a Permit?
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Comments from Conservation Commission:
Approved Conditionally Approved Rejected
All work related debris shall be taken offsite or disposed in a legal upland location
At the end of each day, the area shall be clean and no debris shall be in the Resource Area
Refer to: SE83- or DOA permit
3379
Conservation Commission Sign-off Signature:
Date:
402:03132
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