HomeMy WebLinkAboutAdmin Review 5.17.24 f Y
� +o CONSERVATION
CI € y OFFICE
bdirienzo@yarmouth.ma.us
Yarmouth Conservation Commission
Administrative Review
Applicant Information:Name: 5 Tt r\ ' ckei{t)n
Mailing Address: 1�I n r�,,tt
Phone: Email:DO+ SUJi-V\'xI— "IMiyt i 1 .(ate
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,tjhiss Administrative Review form.
Property/Location of Work: 12 �? 'v
Street Name and Number
Signature:
Detailed Description and Reason for Proposed Work: 1'e L 0 COuY-
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Smc.0 +(Le5 kowe h-un erana-ed. 'L Get-Ecor Al Frees Creed nvopce 0,cocfo )
Sw G\-e. t CLs- 61 I ,S F deep
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Closest Distance to Resource Area: •-0C'
Proposed Start Date:
Company to do Work:
Name.
Address:
Phone: Email:
Administrative Approval:
°Q comma 511/ iz°Z V
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