Laserfiche WebLink
j 16 Great J ccl<Road XY tli <br /> PETITION FOR A MINOR MODIFICATION <br /> Date <br /> Zoning District <br /> Print <br /> Property Address �a C-11-C.) C:�CJ <br /> Petitioner A._r.61 S J S-e-1,2`7119a4 e-- �2 Phone.,�J� <br /> Email <br /> Owner's Name Phone D ��� y�/e/C/ <br /> ZBA Original Docket Number <br /> I <br /> Project is a: [I Deck []Addition El House ❑Other /N aCG�T� �-� �u ld(ILi <br /> Proposed Modification pp 420 eJ <br /> l✓Q G 4W O A /-) C� l���t /G�G JT '� ��'�1�i' z/7 <br /> / S,5 A 2 c/4 P&a-`E Chi ll <br /> i+t Nc_ C /$3 GJ Lt c r1 v�%1 i—�v -..� <br /> Owner's Signature or letter <br /> Petitioner's Signatu <br /> Mail certified copy of Decision to: �. l ! CCU <br /> . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ... . . . . . . <br /> TOWN CLERK <br /> Scheduled Date �� ":, �� �����" ' <br /> DATE STAMP <br /> NOV 1 2 20:1 <br /> Rev2/12/1S k L-`C . 1 . „cr'' � -�.� U..y. .a <br />