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-q3 <br /> 16 C'rcat Ncck ltaa<1,j\Jarlh <br /> �»E Alashpce,iWassacfucsetts 02649 <br /> PETITION FOR A MODIFICATION <br /> Date 1 o��C c <br /> � <br /> Print <br /> Zoning District � J <br /> () � <br /> Property Address t5 t� p � �ry �� P C.� � P <br /> Map: a1 Parcel: 3 <br /> Petitioner 6n&of l JO-Anu-t QA17 Phone 60' e • j &5- `7 q I/ <br /> Email IZect G.-ngu C IM -Si'� `I <br /> Owner's Name k K .d T..e&A S e 60 .Vt V�, Phone 50e- ,S 6 c> ' 3 6-!� � <br /> ZBA Original Docket Number e)K 3a —to a-f) <br /> Project is a: ❑Deck OAddition douse ❑Other <br /> Proposed Modification R Qf5tf�-�- L &JVW(2#4 OC.5J E)C"S/ O0 <br /> Owner's Signature or letter <br /> Petitioner's Signature Mail certified copy of Decision to: �� Aveilv e <br /> FJ ,L ,o v d-t-, 4 M 0 <br /> . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . <br /> TOWN CLERK <br /> y <br /> Scheduled Date J��''2�t�a��� f DATE STAMP <br /> /" �2o�U <br /> iviF', ;i ��' t® ����VVN Gi,ERK <br /> Rev 6105115 O C T 0 8 2020 <br /> DECEIVED BY: �. <br />