HomeMy WebLinkAbout18-A107-A2TOWN OF YARMOUTH ffi +,##rr*fffiffi
1146 ROUTE 28, SOUTH YARNIOUTH, MASSACHUSETTS 026 64-445I
Telephone (508) 398-2231 Ext. 1292 Fax (508) 398-0836
OLD KING'S HIGHWAY HISTORIC DISTRICT COMMITTEE i Ailiolrj r(iNG
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'$ l-iitit-,1lVAyAMENDMENT FORM
(,,M|NOR CHANGE REQUEST")
A minor change request must be submitted within one year of the original approval date or while the work is still inprogress. Only a minor change may be approved by the Committee without the filing of a new application.
PLEASE TYPE OR PRINT LEGIBLY
Original Application
Address of proposed work \ ur{Dr*t'\^\{,!.
Original Approval Date
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Owner(s): phone
Mailing address
Email:
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Preferred notification method. Phone Vgmail US Mail
Agent/Contractor:
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Please describe proposed change(s) and attach plans/photos (as necessary):
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Phone
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Preferred notification method: Phone Email
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Signed (Owner or Agent)/ Date
Approved by OKH Denied by OKH New C/A required? Yes _No
Reason for Denial:
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