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A'T <br /> rollrfl oj'-N, k1sh.pec <br /> i k &oad-,V')rffi 16 (,'iyol�,Nl <br /> 1)](Ishlicc, Alassochuscll-s 0,2649 <br /> PETITION FOR A MODIFICATION <br /> Date <br /> Zoning District <br /> Print <br /> Property Address 4(p PAto <br /> Petitioner Phone <br /> Owner's Name v,_ F Phone (ot <br /> Email J&skU,C( kv-Eg q m <br /> U t <br /> ZBA Original Docket Number <br /> Project isa: E]Deck ElAddition E44ouse 11 Other <br /> Proposed Modification _2 41/— 46 <br /> Current Lot Coverage % Proposed Lot Coverage % <br /> Owner's Signature or letter <br /> Petitioner's Signature <br /> Mail certified copy of Decision to: Q, <br /> L ri <br /> . . . . . . . . . . . . . . . . . . . . . . . . <br /> TOWN CLERK <br /> DATE STAMP <br /> Scheduled Date <br /> Rev 6128118 <br /> MASHPEE TOWN CLERK <br /> JUN 0 12021 <br /> RECEIVED BY:--��� <br />