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TOWN OF MONTVILLE
BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Permit No. AK? y Date cam/
Estimated Cost Fee
c Address Tel
Owner
Contractor Address Tele.
Zone No.
V=aE -
Location of Building
Additions & Alterations (Including moving, demolition, sign erection)
New Building - Type of Construction
Size Type of Heat Fireplace
No. of Stories No. Rooms Breezeway
No. Baths Garage Use
I hereby certify that the proposed construction will conform to the applicable zoning reg-
ulations of the Town of Montville and the Basic Building Code of the State of Connecticut ,
and that all statements herein contained are true and correct.
Signed Approved
Date Building Inspector
Inspections For:
Footings _
Framing
a`Rough Wiring
Electric Service
Rough Heating
Fireplaces
Other Misc.
Final Inspection for .0.
A roved. / 4ejected Signed
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