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HomeMy WebLinkAboutAdmin Review 1.31.24 l Y � C CONSERVATION C OFFICE F ° � bdirienzo@varmouth.ma.us �° Yarmouth Conservation Commission Administrative Review ApplicantI Information: \ l ` /V� Name: F�caKCF4(lbw „1 ci }.69 SI JCV`J\ I' \C n 46\G\ Mailing Address:)) Phone: )Ut --1 45b V Email: \D p Lan 1'4_IL k L Co Ltti_ 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: l,l wAt �-` G1 IC00 \ Street Name and Number Signature: , f-/7 A/(.71 _ Detailed Description and Reason for Proposed Work: ),1\c -di-Cljr Propov.k 40,,.0 rtocILRA ( 1-O0,4 Wd\ lnf kVCV ) PriCtMG4'6c1 �CO 39UG -{- of ack6A, 4Q/VA\ Mti-tc rn--to,, p\at).-Is dtcer.k1 cb I1 Proro Closest Distance to Resource Area:Ali,fi\A,1 SOk �lB lg COC, TQt V C✓, k_ Proposed Start Date: fl- )Y 4 1 Company to do Work: Name: Address: Phone: Email: Administrative Approval: 110 4)PR CQM(DJ'g14 5SC 1-0 CIOV'_CLQ (PVv9.cdl ?ioe' t 4 n s>�� /V ? t lyIarQv \ 1;l1z�t 3� TckA,3-`°^c^\ 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