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HomeMy WebLinkAbout2022 Sign off transmittal - Honey Dew / Build out 1,000 feet RCC�Ls TOWN OF YARMOUTH Alsi 2 5 %.C7.4 .0 HEALTH DEPARTMENT S' —, � HEALTH DEPT. PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET 4. To be completed by Applicant: Q . , l� r Building Site Location: 5S2 7 _8 '`o a? !L1t S+ Thi 4h- Proposed Improvement: /11 DLL., x©,,,,14 - LAI c.- a d o o sr-F4 • • • M, 1 A . , . Applicant: / U .t o p Tel.No.: 7 741—g01't!11 boAddress:_ PJ 904 13 8 o v 41, Nz4sAs, 144 Date Filed: Po **Ifyou would like e-mail notification ofsign off please provide e-mail address: e I1 oAt AeL., Cr cd. Co/14 J/ Owner Name: fr �e-y/v Owner Address:r+ - 2/ 2_7 Owner Tel.No.: 2` u t{ tC 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: jiA÷/� DATE:_//$56/94R $.6/ PLEASE NOTE COMMENTS/CONDITIONS: