HomeMy WebLinkAboutAdministrative Review 9.8.23 `1 . 4.k4 CONSERVATION
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.-,;; --' Yarmouth Conservation Commission
Administrative Review
Applicant Information:
Name: V.N,'( (-6VC lC CMA
Mailing Address: l k( f\d J*ArN I
Phone: Email:
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 Review form.Property/Location of Work: ?wVC4 f -) I 1 v k r eG On 05 7 Sc tJ-fin S"\0({ Dr
Street Name and Number
Signature: ,,
Detailed Description and Reason for Proposed Work: �p•'-e 1 J"€ s c(`e4 O.&7 6,(ei
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Closest Distance to Resource Area: ` CI G 3TG \ -o`c k , PTC t- toac1 Td
Proposed Start Date: O`1 \ 01 G-P+4r Se0s. 15 207.5
Company to do Work:Name: 1CAI M ?OLAV\ � W++
Address:
Phone: 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
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