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�`fuss <br /> .,,•�, SOW Of lLashpee <br /> s s , <br /> 16 G$i(111 0 ek-Read.41.1h.' <br /> h](1811per Niallsaiquisetty 02649 <br /> PETITION FOR A MODIFICATION <br /> Date _ �.. <br /> Print Zoning District ', <br /> Property Address_ V 4 1 v t cy- TTZA l L <br /> Map: Parcel: 0 7L 4-t <br /> Kkiic,+J ccL �, <br /> Petitioner <br /> // SSCt't'Net`> 'P, Phone_-7-7q-Z72-O?�8" <br /> Email_ h:&L, xCt-1-)aeri` R r !.!55 .Cc ► <br /> Owner's Name Phone-7 74-ZR G.-40 3 <br /> ZBA Original Docket Number V--ZO(9--19 <br /> Project is a: ❑Deck CAddition 0 House ❑Other <br /> Proposed Modification _ TZ&-f,-.tO\ �5C b✓zCl4. <br /> Owner's Signature or letter .. <br /> Petitioner's Signature <br /> Mail certified copy of Decision to: &rL--4 ' Cobr- <br /> ■r ■ ■■■ ■ Yq■ ■ ■ ■V• ■ ■1■ ■ 1■q ■ ■■11 ■ Y>f■ Y ■1■1 ■ Y® ■ ■� q Y� ■ ■� Y Yq■ ■ ■ ■q■I ■ ■1■f ■ Y■■I ■ 11■q ■ YYl ■ • <br /> I <br /> TOWN CLERK <br /> Scheduled Date DATE STAMP <br /> Rev S13112017 <br /> I <br />