HomeMy WebLinkAbout2007 Apr 06 - Sign Off Transmittal Sheet, Plans - Shed Roof Addition for Laundry Area �--- �.
,�°��Y"R� TOWN OF YARMOUTH
o � c HEALTH DEPARTMENT
N .,,n� � �, �'
��`"'""p5p�'� PERMTT APPLICATION SIGN OFF'IRANSMITTAL SHEET
To be completed by Appdicant:
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Building Site Location: `� � � � �-�i{�� Map No.:�� I.ot N� W
Pro�osed Improvement: 1 �1 U f Yl X
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Applicant: �C�,�I c�iZ I �/'1 O YY�Q.. �C�`l I�OU C�(Yl�� Tel. No.: �� ��S � p
Address: J�Q �-1 S 1 IQ�.I.��U� ���C,(� Date Filed:T`� -��_
ttlfyou would like e-mail notificadon ofsign off,please pravrde e-marl address:
Owner Name: tlC�-�Z�"!- F-��t� I`� �U U�.2--
Owner Address: CJ W a �}(, G( I � �� . Owner Tel. No.�}`�.QU -��
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RESIDENTIAI.AND/OR COMMERCIAL BUILDTIVG .
HEALTH DEPARTMENT: Determines Compliance to State azid 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 ea�isting buildings, water line lceation, �'�
and septic system location; I
(2.) Floor plan labeling ALL rooms within building �
(all eSisYing and proposed)—
Note:Floor plans not reqsired for decks, sheds, wixdows, roofing�
(3.) If necessary,'Title 5 application signed by licensed installer
with fee. -
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REVIEWED BY: , DATE: �/C�� [
PLE"iiSE NOTE I'
COMl�1ENTS/CONDITIONS:
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