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Town of Montville
Building Department
848-3030, Ext 82
ONE &TWO FAMILY
CERTIFICATE OF OCCUPANCY
SIGN-OFF SHEET
Property Address
Job Description: M4 (I rc; r D ( -1)Q1, ® � 1
The owner/agent shall be responsible for the completion of the form, no certificate of occupancy will be issued until all
signatures below have been obtained.
HEALTH DISTRICT 848-3030-882
Approved
❑ Permit#: a Not Applicable
Septic System Date
Approved
❑ Permit#: in Not Applicable
Private Well Date
WPCA DEPARTMENT 848-3030,Ext 881
Approved
0 Permit#: 0 Not Applicable
Municipal Sewer Date
Approved
❑ Permit# ❑ Not Applicable
Municipal Water Date
DEPARTMENT OF PUBLIC WORKS 848-7473
Approved
❑ Permit#: /►:l Not Applicable
Director Date
PLANNING&ZONING DEPARTMENT 848-3030,Ext.81
In-Compliance
t✓ /C0/0/(J Permit#: (Not Applicable
Zoning Date
54' In-Compliance
❑ Permit#: Not Applicable
Inland-w etlands Date
Town of Montville Ai
Building Department 111,
Date �/ t3 /,p? Field Inspection Notice Permit 1,6202Q0,7—/za
Job Location /p2\3 �� ye, 5)( ,
2(Approved Type of InspectionF.? / C 3
Not Approved - Please call for re-inspection when the following corrections have been completed:
APilm OIC-
/)5
Build C cial
Town of Montville O.
Building Department
Date //Z / ,e)( Field Inspection Notice Permit #E.02000? /a 5-
Job Location J a 8 Park /A,/e,.
Y'APProved Type of Inspection Af
mc- .
Not Approved - Please call for re-inspection when the following corrections have been completed:
Building Official