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d`S�lf{16,F i, cr c r <br /> �kyi l�'LutrftJr(rrr, ?X��rt:(rur,Irurar,dlej f),:(�AS3,' <br /> PIA1110N FOR 811"1 L-P+I- <br /> pvt--M6I, ('ba ytor 40A 49 aiA Towle of Mash oe Zoning B T a`wsWof 1987 <br /> I2tttc .:. .-_ - ..... _ ry ..... . ' Zoning District .._— <br /> 11roporty Address _ ..� w _. .��.....�� <br /> oS <br /> Map. ._. Parcel <br /> Phone <br /> Email ���'F'����r! � t�jl '►�1 <br /> ®wncr's Nam 42/ 84614 thane <br /> Is this property Within the Pro-contact or the fest-contact Archaeological Sex�sitiv�ty areas DYES C1NQ <br /> AppCying fir(Check approl mate box(s)):' <br /> [-1 Accessory Apartment ❑Commercial ❑Sign ❑Bed and Breakfast ❑Private Nonprofit <br /> ❑Hospital/Nursing Home ❑Outdoor Recreation ❑ Indoor R6cre6ilon ❑Docks <br /> ❑Lumberyard s/Landscaping ❑ Automotive Repair D.Drive In ❑Wheless Servicos; <br /> ❑Medical Uses ❑Kennel ❑Retail Sales El Eating EstablishmontIT <br /> Cl Other <br /> BRIEF DESCRIPTION <br /> Owner's Signatwe or letter <br /> Petitioner's Sigxahtre / MAHPEE TOWN CLERIC <br /> NAV 201 <br /> Mail certified copy of Deci ion: to: _ <br /> RECEIVEDBY <br /> A a YNIYt a-ama y a rmy w. r® r lam a am P �:.lr' �. K 60 11 eem a *M -a bm" -w xwm W m.ot1 w ON* 0, a®" a "M 0 aaK y:_ <br /> MASHPEE TOWN CLERK ; <br /> Scheduled Date � C�, �� r TO'4�V1�T CLEC <br /> RECEIVED:BY >� a <br /> Rev. 5/025/16 <br /> f <br />