Town Of Newbury
The Conservation Commission
Newbury, MA 01951-4799
SITE VISIT AUTHORIZATION FORM
I ______________________of _____________________ (number/street)
Give the Newbury Conservation Commission, its agent and members, and the Department of Environmental Protection my permission to enter and inspect the above stated property at all reasonable times to acquire any information, measurements, photographs, observations, and/or materials deemed necessary for the evaluation of any permits required under this application.
Printed Name: ______________________________________________