HomeMy WebLinkAboutAdmin Review 6.13.2025 O 1(4
CONSERVATION
}Q OFFICE
0 H bdirienzo@yarmouth.ma.us
NCORPORAIEO N4 Yarmouth Conservation Commission
Administrative Review
Applicant Information:
Name: 3 LAOlJ+ I -aCl " -/---Jshe
Mailing Address: 3 ) 1 h h R O 3 e
,..
Phone: (0o D -V 9 9---(de Its, Email: f 7 /19 C--L ( i / e#
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: \ 1 1 'f G,►^ r d tA4-N pU rf ) )11
Street Name and Number
Signature: i4 JJY (J ;;_
Detailed Description and Reaso for Proposed Work: r
ifil'101-/ / 0 vi&F/14. 044) etese 6'4 1<_-ve-_
wI ti 5fU - , �P YJifrt, (/PZ/ () Eirir.t5 ,
Closest Distance to Resource Area:
U �
"/C)
Proposed Start Date:
Company to do Work:
Name:
Address:
Phone: Email:
Administrative Approval:
i _
71/4 Leee , —** --- /7 ./
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
rev 3/2025
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