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31D-020 Smith College-Paradise Pond management dam repairs-extension-2017Bk: 12621 Pg: 329 HAMPSHIRE REGISTRY OF DEEDS DOCUMENT COVER SHEET For use with documents that do not meet document formatting standards. Information from original document takes precedence when indexing data into Registry system. For Registry Use Only THIS IS THE FIRST PAGE OF LEES DOCUMENT -DO NOT REMOVE PROPERTY ADDRESS: COT Lifer DOCUMENT TYPE: e - NAME REFERENCE: 1J8 04'' &rte. caul Important: When filling out forms on the computer, use only the tab key to move your cursor - do not use the retum key. Bk: 12621 Pg: 330 Massachusetts Department of Environmental Protection DEP File Number: Bureau of Resource Protection - Wetlands P-16- S$� WPA Form 7 - Extension Permit for Orders of Conditions Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by DEP A. General Information 1. Applicant: tott Name 1- Mai 'ng Ad ess r 14WirtOlet MH- °(0603 City/Town State Zip Code 2. Property Owner (if different): Name Mailing Address City/Town State Zip Code B. Authorization The Order of Conditions (or Extension Permit) issued to the applicant or property owner listed above on: wz. v U, OO7 Issued by: ' '" ^ p. ate n ' , Lam for work at: Street A ess Conservation Co rf mission record at the Registry of Deeds for: c U Tshire tY ©l5 et. o(1 Assessors Map/Plat Number Parcel/Lot Number Certificate (if registered land) �r(Al4a gut, aoto, G 1# . 4c - is hereby extended until: rate date the Order was last extended (if applicable) This date can be no more tha years from the expiration date of the Order of Conditions or the latest extension. Only unexpired Orders of Conditions or Extension may be extended. %aq0 Book iagD This Extension Permit must be signed by a majority of the Conservation Commission and a copy sent to the applicant and the appropriate DEP Regional Office (http://www.mass.qov/deo/about/region/findyour.htm) wpaform7.doc • rev. 3/1/2010 ATTE5Ti ITAMPPIREE l ��,o9t��7 / / \ Date ari/t-6\-z MARY LBERD , REGISTER Page 1 of 2