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Application Number <br /> Checked Dale <br /> ,Y v+�•.4r <br /> P.O. Box 1108, Mashpee, MA 02649 <br /> 508-539-1443 D@@Ogn <br /> Applicant My..AmAwnt) S, CopizEtA -Day Phone l-968- 54 B- 44U <br /> Applicant's Address DuNI(IN OcrvuTsSlacr 6l4 Mikiki STea--T hluMacT'A AAA 02540 <br /> Representative(it any)NeesmlGg3uw,J,.,SL1.Swiue&W-Aycµrrc-cTs Day Phone6�l7-cl /8 -1953 <br /> Representative's Address IGT-A U/ASNIr.WTotjSrtza-T, Ucj2uJL-L : MA ozo <br /> Property Owner(if other than applicant) Uou,&yy F. a NeLm F. Revs-uug <br /> Owners Address R24 Matti6-r. FnLotauTg MA. 025-40 <br /> Please indicate if all correspondence is to be sent to_the applicant_Zthe representative_the property owner <br /> What do you want to do? I3Ute✓J A QV LLbtN,i W Nice+ w0uu� l AJCLV0e A 21,',Okiru DONa19SL40P J, PCTA1L S b1UPS <br /> What is your final goal? <br /> Project Address _Ae L30 40, MAtu STe"-r, MA514FG—, (VIA. <br /> Name of tract,development or business RFTALL !940 PS <br /> Legal Description: Lot 0 10 Block Tract <br /> Assessors Parcel Number 28 Present Zone/G.P.Designation L- Z <br /> APPLICANT/REPRESENTATIVE:I have reviewed this completed application and the attached material. The information provided is accurate. <br /> I understand the c9 might not approve what I'm appi..*no for or might set conditions of appro,�vjjall- <br /> zti /U011,AfA/- 19,1994 <br /> Signed Dated <br /> PROPERTY OWNER/AUTHORIZED AGENT: I have read the completed application and consent to its filing. <br /> j/(.k _"o," S% NOV 13 i 9 96 <br /> Signed Dated <br /> Received by Date Receipt No. <br /> Permit approved by Date <br /> Comments <br />