HomeMy WebLinkAboutAdmin review 6.16.2025 f YAK'
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OFFICE
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�COAPORAT E� ' Yarmouth Conservation Commission
Mar
- Administrative Review
Applicant Information:
Name: -v/TLid.Oa gl(--in/P--
SAMailing Address: 6 � �2 j Q M.e i/ae_ 41 " Oa / 7
Phone: ( 7 ) as"
( 5 7 / O Email: 02-/tri'it 'R//631, M-e. c971,
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.m.n /�/f
Property/Location of Work: �vJ' '` , - (///`eu/'•e /8- 7 `- %f-4 J �e, V "�
Streetkrne and Number
�(. y. / 2041
Signature: 4,., / cf,-)....c.„.....„._
Detailed Description and Reason for Proposed Work: 1'��
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fIa11 -)---S 40 y — Co i 1 U 'Y'y1!t j f4S
Closest Distance to Resource Area:re A Proposed Start Date: c c / 1 7-S - 7p f'O 1J4 (----
Company to do Work: 1/0e_,
Name:
Address:
Phone: Email:
Administrative Approval: i
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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
rev 3/2025