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klkla <br /> Town of MashpeeAPPLICATION <br /> PLAN .r <br /> _: 4 <br /> _ Application Number <br /> REVIEW <br /> �W .� -�� - Cnecked by Date <br /> Applica`t Day Phone ._ <br /> rVicant's Address <br /> ;Representative(if any) Day Phone <br /> Reoresentative's Address <br /> Property Owner(if other than applicant) Day Phone <br /> -Owner's Address <br /> Please indicate if all correspondence is to De sent to the applicant : the representative the property owner. <br /> What do you want to do? <br /> What is your final goal? <br /> Project Address <br /> Name of tract.development or business <br /> Legal Description: Lot Block Traci <br /> assessor's Parcel Number Present?one;'o.P. Designation <br /> APPLICANTIREPRESENTATIVE: i rave reviewed this Com- PROPERTY OWNERIAUTHORIZED AGENT; l have rear <br /> ieteo application and tine attached material. The information pro- cornoleted application and consent to its tiling. - <br /> vicea is accurate. t understand the city mignt not approve what I'm <br /> Aa001ying for.or m,gnt set conditions of acprovat. <br /> n <br /> S <br /> Danz <br /> sjgnep Date <br /> Received by <br /> r <br /> Date Receipt Na <br /> Permii evproved by _..��, .�..._._,!.l..l. l�., .,_.l.�Date <br /> Comments . <br /> .` <br /> [Eby <br /> f"<f <br /> !y_V <br /> 5• <br /> .L' k <br /> SSSSSS i <br /> f <br /> I <br /> f <br /> i <br /> I:� <br />