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r• <br /> oNi [)titi,y <br /> Town of Mashpee <br /> APPLICATION <br /> 4�y,pRals•Y., f/� <br /> •- I <br /> JP <br /> PLAN <br /> " Application Number <br /> REVIEWChecked by <br /> Date <br /> i <br /> Applicant � � �S Day Phone01 <br /> Applicant's Address ig��(947 <br /> Representative(if any) D Phone Day o e <br /> Representative's Address <br /> Property Owner(It other than applicants <br /> Day Phone 77 <br /> 10 <br /> owner's Address / �.. !rc. , •- <br /> Please indicate if all corresponCence is to be sent to Ell the applicant the representative : the property owner. <br /> What do you want to do? AU l 0 � <br /> What is vu r final goal? � s �'�Cr / " ]� �+r�+ . ,�-- <br /> f <br /> Project Address � � �� s <br /> Name of tract,development or business <br /> Legal description:--6ei.' 'Block Tract <br /> Assessor's Parcel Number <br /> W191:"- Present Zone/G.P. Designation <br /> APPLIGANTIREPRESENTATIVE: l have reviewed this com- PROPERTY OWNERIAUTHORIZED AGENT: l have read this <br /> pleted application and the attached material.The information pro- completed application and consent to its filing, <br /> vided is accurate.l understand the city might no approve what I'm <br /> appl Yin r.or might set conditions Rf appr 1. <br /> Sig �; Date Sigl6ed <br /> Date <br /> c00 <br /> Received by .,,._„.._ ..�,.,... Date Receipt No. <br /> Permit approved by Date <br /> Comments <br /> AlVl <br /> �4 <br /> .3' <br /> is <br /> v <br /> r4 <br /> :3 <br /> fe <br /> • <br /> • R• <br />