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HomeMy WebLinkAbout2009 Sign Off Transmittal - Bedroom and Bath on Sona Tubest TOW]\ OF YARMOUTH HEALTH DEPARTMENT PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET Tb be compleled by Applicant: Building Site Location: Proposed Improvement l7s 9€aur t* A L/€f4na*No.: lnt No.:.fo F-+ PA rO 13€of*m + R47-/t Cra Scnn a. c App licant:l g 7ll I ph Lf; t) 57t"s Em fofie,yr Tel. No.:3rP ' 1'7t ' l7-7 P C 1 /3*4rsTag/a rT/)t"l Date Filed: g' /a' "rtll"s **lf Wu woul hke e-mail notilicdtion olsign ofi, pleose prwi& e-mail address o*r,o Nai,"' /?o €o'" l< 'uuo 3u- OwnerAddress: )7f s€4v, tr4fr 9o ?4/?Owner Tel. No.J , f - rt?^ 3"e? 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 {!! rooms within building (all existing and proposed) - Note: Floor plans not requiredlor decks, sheds, windou,s, roofing; (3.) If necessara, Title 5 application signed by licensed installer with fee. DATE {f, r/oZ c "fb /be-'r^-,.-, [ fi-Jvo.,-,-S Address: / RESIDENTIAL AND/OR COMMERCIAL BUILDING REVIEWED BY:f,t PLEASE NOTE COMMENTS/CONDITIONS:fi f +-I/:F1'l- F .(1 Fr --s\9x.f(1\ I-r- snez a t ',) O")T( P cti! l? 6l e $ c! s S i I {."4' t^ t C -A i v F n *a(g -42 z(- o N, =.i r-l l -tvf l-l 6iirtl ,, . ,\Vl"l r ^tl \N0 .i 1 I I I I 9t-rir lr tuAl E L 4558990R5',r ----32 --*32+ 9ilr9 24X5 40 MIL HDPE PTASIIC UNER, fiSrAU-@ BETWEEN EL-49.63 AID ELA45.63 TO PREVENT BRr}KOUT PROFOSED RETANING WAI'I TO EE APFRO\r'ED EY OWNER, ONE RR TIE IN HAGHT (6't MINIMUM) TO CREATE FLAT APEA IN YARD ToF EL=49.6 MINIMUM 14,.6 6ool') .9 52|r&_o_ TPo 9T ?c DE t,n ruRE ADDmON N $t d rra5a 'lzre.erll; trJ ar.7!< 9AS Ragcrva cQr T 59 I(oN Nqt si\ >IU IU a) rLo o 3A.96' PIAN SCNf il:20 THI9 AREA 15 SERVED BYTOWN WATER. 50 EE E F B IF?*q 2 ;F J<o, P6 E<o=g6 EH.oatj<n -B;=<a;!E ao @FffqlL ==tl.lA, c.-.t (]Fc.Ji8q-tro=t IUUI = uj@- a9.ao 0r ALBK}S o.t rr, J6. Ho. 1206t tsENCHMARK: Top of Concrete BoundeL=49.36 (Assumed) REMOVAL ir) 1.. tvca:7,O47 5fx. LOT 9I 50.tor%-_ w -:oJ i r t -t t2'