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HomeMy WebLinkAbout2014 Aug 01 - Sign Off Transmittal Sheet, Plan - Move Garage to New Location � �a. __,.. _ _:__ � .w,. .�._�� _.. _ . _ _—. � _ � - __ __ of��x,y TOWN OF YARMOUTH y�' •.:�c HEALTH DEPARTMENT o � -� � '�•�••`' $ PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET To be completed by Applicant: � Building Site Location: �� w"""�`' ��� �p� �r �".—�1�� 4'posed Impmvement:�sv� �l S�� ���, 9Cr��-�ie d-o y�y_u.) �oC o��B^-� � �� _ c� Q Applicant: �d� , �otSS�5 � �76��- ��C— Te1.No.: �O� l �`ll�O � Address:� 36 O�`O'��`�� C.t� g��5+� �� DateFiled: � �� •*lfyou would like e-mar/notifrcation ofsign ojj;please prwide e-mail address: � �m ev�,� ' S C{/�� /`-��`���' � � �G�-- � Owner Name: ��� �" ��-J�` C� ;; �� S ! i �s'r�fj- Owner Address:s� re t�r (��"��s �awQ-- Owner Tel.No.� � L� N�C�w�m � C7— d� 8� _........._......... .._.................._..._..........................�.................................................. ................................................................................ .............._............... RESIDENTIAL AND/OR CO�RCIAL BUILDING HEALTH DEPARTMENT: Determines Compliance to State and Town Regulations; i.e.,Requirements For Septage Disposal and other Public Health Activities. Please submit three (3) copies of plans, to include: (1.) Site Plan showing existing buildings,water line location, and septic system location; li (2.) Floor plan labeling ALL rooms within building � (all existing and proposed)— Note:F[oor plans not required for decks,sheds, wendows, roofing; � (3.) If necessary, Title 5 application signed by licensed installer with fee. ........._....._......._....................._................._....................................__....................................................................................................................................................................................... ...................................................._....... 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