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_ <br /> !ti C:3rfsaB rA'i,ck 1�aacf riA`ortla <br /> �kti57urlx t.+r` .t,,x�Clb`1"!]�f C AlCtS,"iCI(.husQ tit 0,2649 <br /> PETITION FOR P I L PERMIT <br /> Per MGL Chapter 40A §9 and Town ofMashpee Zoning By Laws of 1987 <br /> f <br /> Date Zoning District <br /> Print .--- "12 off. <br /> Property Address <br /> Map Parcel <br /> Petitioner . 4, "`--- Phone <br /> Email ` , ) <br /> Is this property within the Precontact or the Postcontact Archaeological Sensitivity areas ❑YES ❑NO <br /> Applying for (Check (xppropriate box(s)): <br /> Accessory Apartment ❑Commercial ❑Sign ❑Bed and Breakfast ❑Private Nonprofit <br /> F]Hospital/Nursing Nome DOutdoor Recreation ❑ Indoor Recreation L Docks <br /> ❑Lumberyards/Landscaping ❑ Automotive Repair ❑Drive In L-iWireless Services <br /> ❑Medical Uses ❑Kennel ❑Retail Sales ❑Eating Establishment ❑Other <br /> BRIEF DESCRIPTION ,a 1 � ... . 41, <br /> '. t O <br /> Owner's Signature or letterR011319EYC. COLLINS <br /> r /` <br /> Petitioner's Signature _....__ Town Manager <br /> Mail certified copy of Decision to: <br /> 9 9 1 9 . 9 ■ 6 ® ® . 9 9 . Y Y . Y ® v R v Y 6 . ■ . 6 ® a <br /> MASHPIE 1SQWpCCEW <br /> Scheduled Date <br /> DATE STAMP <br /> AUG 2 6 2016 <br /> Rev. 3106115 RECEIVED BY. ` jLq.' <br />