HomeMy WebLinkAbout23-A031-A1 34 Cottonwood St ApprovedxTOWN OF Y A R M O U TECEIVD
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Telephone (508) 398-2231 Ext. 1292 Fax (508) 398-0836 JUL 12 202
01.113 KING'S HIGH«'A1" HISTORIC DISTRICT CO,%I'%IITT
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AMENDMENT IFORM ow KMM MQW&
("MINOR CHANGE REQUEST")
A minor change request must be submitted within one year of the original approval date or while the work is still in
progress. Only a minor change may be approved by the Committee without the filing of a new application.
PLEASE TYPE OR PRINT LEGIBLY Original Application #: 93— /"3 � _ Original Approval Date: 101
23
Address of proposed work.- % .
Owner(s): , J1 A AA to
Mailing address:
Email: C� e 9V&t—
Agent/Contractor: UU /7,,, ;
Email:
Please describe proposed change(s) and attach pl
6-914 co e
r Phone #:q 71Y 7510
Wr4?erred notifi ation method:_Phone —Email —US Mail
Phone #:_=() f [J l9 l9 �6
Preferred notification method. Phone Email
(as necessary):
70
Signed (Owner or Agent) Date p
.....................................
..... , /
/,,Approv,e,db,y,0,KH
Denied byOKH New CIA required . Yes V No
Signed OKH Chairman �,lhS Date
1 a3
AMENDMENT # ;�77- A13) _14)
11/2015