HomeMy WebLinkAboutWater sign off 3/2/23 WATER DEPARTMENT
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MALI)ENG PERMIT iti>P1.1CATION FOR
WATER DEPARTNIENT SIGN OFF
URANSMITTAL FORM
HI,it Dimi syli, toc,vi:RA: 26 Musket Lane, YarmouthPort
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PROPOSED WORK: Small 8 x 22'addition to house an entryway. bathroom and walk-ln closet
APN ICAN F: Lesley Moore(Contractor)for homeowner MichaelBlatz.
PO BOX 982,Orleans, MA 02653
ADDRESS: ...,....__. . .
1 ELPHONE: (617)331-0659
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RESIDENTIAL AND :OR CONIMERCE11 131 11.DIN(i
Vi, r. Ikpitinneilt 1)cicritime t_iimpiwnce ol Wiitr ‘%.,iii‘ill.iii,. :uii ,1-i,.xstitig ii),:mon
Fngirtecriiii!Ik'riArtment- Dcternmcs( iimpiloocc for 1- kiqi nid Ilintmai.tc
Con,.tirk itiori Comm DiJimim.-,Ciiiupliiince n Wvilitiki,.N.0. i i° I t 10`,t•';hordin an•:. ty0c
llivik strcaris pimils,ril.Cr.,,iii:e.m.,h ,bo,,,,s, 111;a41:Arid En'
!lath Derottineni I ktei f MI It:°•>( oinpigince to Siaic:nid 1.own Ketiii
requirements 1or Stiptage fhiposal and odic/ Pubhc I ka!th Aci..t,,:ies
I ire Department Duirininoii Compliance to Stalc and 1 ou n RequilemeniN tot Pcrsotia1
Sii lily Pioricrty Proteknorii.,i c. Siniikc Delectins,Sprinkler Svstems.cti.:
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LICANT SIGNATURE D VLF
OFFICE USE:COMMENTS ON PERNIfT APPROVAL OR DENIM
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REV/IAN 71/RV WATER DIVISION(SIGNATURE
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DATE
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