HomeMy WebLinkAboutAR 8-19-22 approved 01.--Y-1144
ri CONSERVATION
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Yarmouth Conservation Commission
Administrative Review
Applicant Information: 1/
Name: , _/a -A,alf\. k 4DJ -S
Mailing Address: ,_4.---4- 2.1 C ..PA 1( ----ek -i /�"Ar.� A.,0_J j U I I
Phone: t j "Z.(v.2_ " 1 Z. 6 -S Email: c1'. e-A.-- A-civ ,
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I hereby authorize the individual members of the Yarmouth Conservation Commission and its agent(s)to enter upon the property listed
below for the purpose of gathering information regarding
this Administrative Reviewvi� form. /
Property/Location of Work: .2t1 l ^�t-c '—"`- ' ` �"-'• k r"'t-� 1 IM--A 01-4 G Li
Street Name and Number
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Signature: �j - ! V ----
Detailed Description and Reason for Proposed Work: At./.„4.. TA.ey- 7.2) Ig.. Tv-4 t X12
Closest Distance to Resource Area: I.D 1
Proposed Start Date: C3 t,,,.-1
Company to do Work:
Name: OA«C/Q "t/.(----
Address: 7 0 r -L,)-__ V2-rk V A.c�_sk I j -0 2_6,k T
Phone: -C v i — 3 U L - 13 Email:
Administrative Approval:
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This approval is valid for one year. This Approval does not grant any property rights or any exclusive privileges;it does not
authorize any injury to private property or invasion of property.
Yarmouth Conservation Commission•1146 Route 28,South Yarmouth,MA 02664•(508)398-2231•Ext 1288