HomeMy WebLinkAboutwater sign off 5/2/23 =O1_•v TOWN OF 1'4R\tOUTI I
3 ,, Cc WATER DEPARTMENT
99 Buck Island Road
F'�. .".!,Tie West larmouth,.\1i(1 6-1
Vi..p`ione: 08)771-7921 • fas:' iii3,7-1-'7)5
•
BUILDING PERMIT APPLICATION FOR
WATER DEPARTMENT SIGN OFF
/� TRANSMITTAL FORM
/ BUILDING SITE LOCATION: 2I k/ 0-8
2 PROPOSED WORK: R4, 2466176 ,PyT Gjj�PY
APPLICANT: c_S�//Y7612D /? c0/7-1— 4646,1 �dd7r/ ,.4;441y-
ADDRESS: /�J {-T 8
7F.LPHONE: 003--93(--9'64
RESIDENTIAL AND OR C'O\IMERCI\L BUILDING
Water Department: Determines Compliance of Water \sadabiht)and oresistinn location
I;ngii eerinp Departnteni' Determines Compliance for Parking and Drainage
('oii cr\ation Commission I)eter:nines Compliance to Wetlands,\cC i e.II'logs)border any type of
netlands.streams.ponds,risers.ocean.bogs.bo)s.marshland.ETC'...
I ledth Department: Delenttincs Compliance to State and FM n Regulations,i.e.
requirements for Septage Disposal and oilier Public Ilealth Actitites
Eire Department: Determines Compliance to State and-Town Requirements for Personal
1oiiyy,Pro y Prate ns,i.e.Smoke Detectors,Sprinkler Systems.elc
- ...4." °'1.. - itgA-9 2..--2.
PkAPPLIC SIGN:\ D\TE
OFFICE USE:COMMENTS ON PERMIT APPROVAL OR DENIAL
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RF:VIF: ED BY RATER DIVISION(SIGNATURE) DATE
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