Plan of (short descriptive of project)
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Street address
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Block Lot Tax Map No.
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Zone Scale
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Applicant name
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I CONSENT to the filing of this plan with the
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Board of the Borough of Chatham
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Landowner
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Date signed
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Name/title
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Applicant
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Date signed
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Name/title
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I HEREBY CERTIFY that I have prepared this Plan and that all
dimensions and information are correct.
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Name
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Date signed
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Title and License Number
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I HAVE REVIEWED this Plan and certify that it meets all codes
and ordinances under my jurisdiction.
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Borough Engineer
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Date signed
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To be signed after the issuance of a construction permit: I
HEREBY CERTIFY that all the required improvements have been installed
or a bond posted in compliance with all applicable codes and ordinances.
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Borough Engineer
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Date signed
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These plans have been approved by the
Board of the Borough of Chatham by Resolution entered on
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Chairman
Name
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Date signed
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Witness to Chairman's signature:
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Administrative Secretary
Name
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Date signed
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