HomeMy WebLinkAbout2007 Dec 27 - Remove Porch; Addition �__.� U
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. � °�.Y`��4�o TOWN OF YARMOUTH
✓ o$ _ ; HEALTH bEPARTMENT
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PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET ,
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To be completed by Applicant: � 4 ` ',
Building Site Location: /S LvEccc�J L,�J �ll, k'v,pnap�� Map No.: Lot No.: ,3(0 '
Proposed Improvement:��,,.,pU� �Y,cT�.✓� �,e�,µ Anl� !n,�i Sr.ac.cr � a� �X .S'�'�\
A D a �T�i�-H A �.� �y�EM,Ed Jr n Al -7HF �6p,E �,c -T.vF ,��c�
, Applicant: SrEVE�) t .�/}��jg- �A�K_ Tel. No.: -r�g 77S 6S'a 9
Address: /s L�f.1�� L„v Date Filed: /� -�C—O 7
**Ijyou would like e-mai!notiftcadott ofsign off,please prwide e-mai[address: S A1 l L;3�f� �' 1/� '��_.id . �1/E�
Owner Name:��uEA) -t /�R�`ff���'f�-
Owner Address: /S � vE_c�,�� �.�1 /.rl.��,2nirkrrff Owner Tel. No.: S-a8 �a5" �5�9
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RESIDEiVTIAL AND/OR COMMERCIAL BUILDING
HEALTH DEPARTMENT: Determines Compliance to State and Town Regulations; i.e., Requirements ;
For Septage Disposal and other Public Health Activities. '
se submit four (4) copies of plans, to include:
(1.) Site Plan showing eaisting buildings, water line Iecatiou; �
and sepfic system location; '
(2.) Floor plan labeling ALL rooms within building ',
(all exisfing and proposed)— '
Note: Floor plans not required for decks, sheds, windows, roofing;
(3.) If necessary, Title 5 application signed by licensed installer
with fee.
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REVIEWEDBY: DATE: id,I�7�LT '
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PLEASE NOTE � '
CONIMENTS/CONDITIONS:
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