HomeMy WebLinkAboutUntitled Yom;M a T H TOO CLERK
.ry EC
rtp4 TOWN OF YARMOUTH
Nx _= t H 46 ROUTE 28,SOUTH YARMOUTH,MASSACHUSETTS 02664-445I
Telephone(508)398-2231 Ext.1292 Fax(508)398-0836
OLD KING'S HIGHWAY HISTORIC DISTRICT COMMITTEE
APPLICATION WITHDRAWAL FORM
I(print name) - t r,_('n.—1 iZ(jt,/C21 C1 herby withdraw the following Application(s)
(Applicant/Owner/Agent)
relating to Eco e---- --\--z— . Q A •
(Project Address)
Check all that apply:
❑Certificate of Appropriateness# Submitted on
Approved on:
❑Certificate of Exemption# Submitted on
Approved on:
'Certificate of Demolition# 2 1—A( (l J Submitted on ,t'115/.24-2-- ,
Approved on: H 1 24)1 aca
1
Signed:4 dm* Date: 6i I\ ( Z 1
(A 1 icant/Owncr!Agcnt)