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Tomm of'Mashpee <br /> H� 16 Great d1'eck Road<)%nh <br /> � Est.. tYlas)t�ee,lCassurlrla,srtt.s 02049 <br /> 1 <br /> PETITION FOR A MINOR MODIFICATION <br /> Date <br /> print <br /> Zoning District <br /> ��' � r <br /> Property Address � � t,m t� d',,-0 r. r fe <br /> Map:_ Parcel: S!r2 <br /> q 1 o <br /> Petitioner / ? Phone �1- 7` e Y/9 <br /> Email. vFo c k_aa <br /> Owners Names t f ti Phoneti`" <br /> ZBA Original Docket Number <br /> Project is a: L Deck VgAddition ❑House ❑Other <br /> Proposed Modification ck,01; T _ , <br /> Owner's Signature or letter <br /> Petitioner's Signature G <br /> Mail certified copy of Decision to: f~' �E <br /> 1 b ffiSm O ® <br /> - - - - - - - - - - - - - - 9 ® d e ® D 6tle4H Y . . . . . . . . . . <br /> � A <br /> TOWN CLERIC <br /> Scheduled Date DATE STAMP <br /> MA HPEE TOWN CLERK <br /> &Y 6105115 APR 1 3 2018 <br /> RECEIVED BY. <br />