HomeMy WebLinkAbout2021 Sign Off Transmittal - Finish Basement C
_ APR 0 1 2021
.„, y r ,, TOWS OF Y ARMOUTH
HEALTH rPPT.
::' HEALTH DEPARTMENT
' •,'' PERMIT APPLICATION SIGN OFT TRANSMITTAL SHEET
re)be completed l7 App ie,mI:
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8uildinee Site Location: 1a i
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.•applicant: ilk( U`.C'x) VCU.
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t t :'_i.:t AA ~ Date Filed: 3.._. 2_.I
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RESIDI VI't:tF_AND OR COtE%1ERCIAL. Kt-ll.DIr(;
i(EALTII DEPARTMENT: Determines Coutpliance to State and Town Re;ulationa.i. ..Requirements
For Septae.Disposal and tither Public I[calih Actititics.
Please submit three(3) copies of plans, to include:
(I.) Site Plan showing existing buildings.water line location.
and septic system location:
(2.) Floor plan labeling.ALL rooms within building
(all existing and proposed)—
_'Li+te: Hnur plans not required d frrr rlet';ts.sheds. windurrti,roofing;
(3.) II necessary, itle 5 application signed by licensed installer
with fee. trl
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REVIEWED BY: ;'` DATE.:
PLEASE NOTE
COMMENTS CONDITIONS:
SVERDRUP
SHEET NO OF
JOB
DATE
COMPUTATIONS FOR BY CHKO
IN iN
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