FORM C-1A. Extend Site Plan Review Deadline.NYAJFORM C-1A
DARTMOUTH
PLANNING BOARD
400 Slocum Road
Dartmouth, MA 02747
(508) 910-1816
TIME STAMP HERE
AGREEMENT TO EXTEND SITE PLAN REVIEW DEADLINE
(Please Print or Type)
Date: ________________________
Applicant’s Name: Servedwell Dartmouth LLC Phone No.: 508-328-9859
Application Time-Stamp Date: August 7, 2018
Subject Property Address: 61 State Road (south side of Rte.6)
Assessor’s Map/Lot(s): Map 169, Lots 246 & 248
PLAN IDENTIFICATION (if applicable)
Title of Plan: Layout Plan, 61 State Rd…Prepared for Not Your Average Joe’s
Plan Dated: 06/21/18 Date Submitted: August 7, 2018
The Applicant and the Planning Board hereby agree that all deadlines imposed under Zoning Bylaw Section 16 - Site Plan Review, including but not limited to the Planning Board’s vote
and filing of its decision, shall be extended to: __________________________________.
Applicant’s Signature: ____________________________ Date: _______________________
(or authorized representative)
Accepted by the Dartmouth Planning Board,
Signed: ________________________________ Date: ______________________________
(Signature of Chairman or Acting Chairman)