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Oro <br /> THE COMMONWEALTH CF MASSACHUSETTS <br /> FecVLof ....... ........:......................... ...... <br /> FOR3i 11 <br /> C <br /> APPLICATION FOR APPROVAL OF PRELIMINARY PLAN <br /> ;I <br /> File one completed form with the Planning Board and one copy with,the i <br /> i' <br /> City (or Town) Clerk in accordance ivith the rcujuirements of Section IIT-A. <br /> No......................... <br /> ....................... ......_............. <br /> _><9.g .. <br /> To the Planning Board: <br /> The undersigned herewith submits the accompanying Preliminary Plan of property located in the <br /> r--- /( �' <br /> '•--••-•••••� J......-• ••••......t�iC � �..... fpr approval a. a.talbdivision as allowed under the Subdivision I <br /> City or Tuwn <br /> Control L.•nv and the Itules and Bcgulation• GoverninL; the Slibilivision of Land of the Planning Board in <br /> the City-for Town) of............ �. �. .......................... <br /> f <br /> 1. Namc of Subdivider .....:. . f?Dt��i( o(U.l. ( U r3 ,�� 1.►� t !� ............................ C— <br /> _ <br /> ................ ....... <br /> Address ................ :.... .d..:..... x (lob z lUl <br /> ........ ............... . .��:�....r........... . .mss.... .................................. <br /> 2. Name of Eagiucer or Surveyor ........... ...........I : �n -C. <br /> 1 �X .......��........................................................ <br /> Address ........... ,"latLlLts <br /> TZYL�}11�C t� <br /> Y?=... ..> :.......... ....... ....................................................................... <br /> 3, Decd of property recorded in ............... <br /> Book Sg.O 7 S� <br /> 1, Location and Description of Property: <br /> 1� 1 � �• <br /> - <br /> 8 <br /> ^ ^lam- <br /> Signz:ttiro of aw n; r .... .l`... ...............s........ <br /> Address <br /> i <br /> Hist of the imnivs and addrr-.es of tluv almitrrs o!.1116-4 -!Illdivi-i­, i-t ait.iched. Z`rlifieation will be made. by <br /> Ihr lyan161111, Doanl. . <br /> rurjt Tout Flobas& WAIOWN, Mr_ <br /> 1-3-05 <br /> E <br />