HomeMy WebLinkAboutUntitled YAW—it 1 i€O C:LERK
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�s }� TOWN O .F YARMOUTH
r ? 1146 ROUTE 28,SOUTH YARMOUTH,MASSACHUSETTS 02664-4451
Telephone(508)398-2231 Ext.1292 Fax(508)398-0836
OLD KING'S HIGHWAY HISTORIC DISTRICT COMMITTEE
APPLICATION WITHDRAWAL FORM
I(print name) (14,‘ 0...."61- \\077 1 herby withdraw the following Application(s)
(Applicant/Owner/Agent)
relating to 2,5 (�‘,4, (_AEr1 V i ,1 r •
(Project Address)
Check all that apply: /�
Certificate of Appropriateness# l ./-1 V 61- Submitted on I\Qk- --
Approved
on: 551 \Q 119-
Certificate
a9Certificate of Exemption# Submitted on
Approved on:
❑ Certificate of Demolition# Submitted on
Approved on:
Signed: ' , ,N4.- -- Date: `-k /0-1 1Q63
(Applicant/Owne A ent
S )