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Waiver
DEPARTMENT OF CONSERVATION Town of Yarmouth Conservation Commission WAIVER `Please complete this form, sign at the bottom and return by mail or fax to the address indicated above. " Date: it I, V6�<sli ©/�G'� / 240 hereby waive the twenty-one day time period for a public Name of Applicant or Representative hearing / meeting following receipt of my filing of; ❑ Notice of Intent x`❑ RequestfoOther ( /rTDe�t�erminationof�A/plicability l�Q �Wz • e by the Yarmouth Conservation Commission under Mass usetts General Laws, Ch. 131, sec. 40, and/or under YarmouthWetland Bylaw. The request was submitted on: Date Received in Conserralion Dept. for work at: �✓� T"k9C/": hA�� W,Y Location/ Address of where work will bed e Please be advised that you will be notified of the meeting date, once this application has been assigned to a Conservation Meeting Agenda. I am the: Applicant Applicant's Representative Property Owner ture) v � 720 (Date) Yarmouth Conservation Commission • 1146 Route 28 •South Yarmouth, MA 02664-4492 Tel. (508)-398-2231 Ext. 1288 •Fax (508)-398-0836 • TTD# (508) 398-2231