NEWBURY PLANNING BOARD
FORM C
Application for Approval of a Definitive Plan
Three copies* of this form, filled out and signed, should be submitted with 10 copies of the plan.** together with all information and fees required under Subsection 3.3.1.
________________________, 20_______
(Date of Filing)
To the Planning Board:
The undersigned applicant being the owner or agent or representative of all the land included within a proposed subdivision shown on a plan entitled
by ________________________________________ dated _____________________ 20________
being land bounded as follows:
hereby submits said plan as a DEFINITIVE plan in accordance with the Rules and Regulations of the Newbury Planning Board and makes application to the Board for approval of said plan.
The owner's deed of the property is recorded in the Essex South District
Registry of Deeds, Book _______________________, Page ________ or Land Court
Certificate of Title No. ___________________, registered in Essex South Land
Registry District, Book ________________, Page __________.
Name of Owner: Applicant's Signature and address if not the owner.
Owner's Address:
Received from applicant for engineering peer review fees the following amount: $__________..
(Signature) for the Board Amount Received
Applicant Signature
Planning Board Acceptance of Definitive Plan Application.
Signed: ______________________________ for the Newbury Planning Board
Date: ________________________ 20_______
* 1st Copy to Planning Board ** 10 Copies of the Plan to the Planning Board
2nd Copy to Board of Health 2 Copies to the Plan to the Board of Health
3rd Copy to Town Clerk
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