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Town q °.Wash :gee <br /> � 10 Grcat Xi ck'Itond,N6r!!i u <br /> nu,r.4� Alaslipee,AlassachusrttsWM49 <br /> PETITION FOR A MINOR MODIFICATION <br /> Date ��f Zll� <br /> Zoning District J?11�s <br /> Print <br /> Property Address 195 6JA'D1 -jAcia- <br /> Map: L Parcel: 9,::) <br /> Petitioner 67E\Y et,� CQOr-, Phone <br /> Email <br /> Owner's Narne �44 Phone <br /> ZBA Original Docket Number <br /> Project is a: ❑Deck ❑Addition 20-ouse ❑Other <br /> Proposed Modification NCS sE Dfi-S t&j Ak,D EQZ�5 U <br /> Owner's Signature or letter <br /> Petitioner's Signature <br /> Mail certified copy of Decision to: <br /> . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . r. . . ■ . ■ . ■ . . ..r ■ . ■ i ■ . . r. . . ■ . . . . . . r.. ■ . . . . .m. . <br /> TOWN CLERK <br /> Scheduled Date .6 2ol-2 DATE STAMP <br /> MASMPEE TOWN CLERK <br /> OCT - 2 2017 <br /> Rev 6/05/15uu> <br /> RECEl11ED BY <br />