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aF nrgs Town of Mashpee <br /> �sw 16 Great Neck Road North <br /> " Mashpee, JVA 02649 <br /> 10� <br /> #,*;0h 1U <br /> PETITION FOR SPECIAL, PERMIT <br /> Per MGL Chapter 40A §9 and Town of Mashpee Zoning By Laws of 1987 <br /> Date J!� Z,2�,/ ,gyp Zoning District <br /> Print f 0m�'ry <br /> Property Address � :... .��._...�,,.....,�,�.._.._ <br /> MapK2 "o.......___..............-. Parcel..._�.wwww_......-..w,,,,,..�. <br /> Petitioner. O4 l � J 1 10 Phone 2 <br /> Email r ,d v ' ,, <br /> Owner's Name Hg 1d e l-s 2al A ...... .... .... <br /> Phone.....�.�..�.�...�.�.�.�.�.���.�.�...m�m�m���..�_.._____.....___ __ ___. ,�........� <br /> Is this property within the Pre-contact or the Post-contact Archaeological Sensitivity areas ❑YES Z NO <br /> Applyingfor(Check appropriate box(s)): <br /> ❑Commercial ❑Sign ❑Bed and Breakfast F]Private Non-Profit ❑Hospital/Nursing Home <br /> F1Outdoor Recreation ❑ Indoor Recreation dRaze and Replace ❑Lumberyards/Landscaping <br /> 0 Automotive Repair nDrive In El Wireless Services ❑Medical Uses ❑Kennel ❑Retail Sales <br /> ❑ Eating Establishment [ 1Other <br /> BRIEF DESCRIPTION .� .,.._._ , � ..........._.. Mw . w.. °.. �M .' ,. .. .w...._.,� <br /> 9w...........a_. _._..._ _�.. <br /> � � <br /> Owner's Signature or letter( ............ � <br /> Petitioner's Signature � ' �_ ? <br /> Mail certified copy of Decision to: . <br /> ■.m. . . ■ . ■ . ■ . ■ . . . ■ . . . . . . . . r .r. • rr • rr>. ■ ■� ■ ■.■ r r� • r. ■ � r � ■ � <br /> �� <br /> Scheduled Date `� , �`�� ��� .�1...._ �' : TOWN CLERK <br /> DATE STAMP <br /> *mm M <br /> i" , fi LL [OWN CLERK <br />