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C I r M N SALT F MASSACHUSE 1 ;S <br /> TOWN F MASHFEE <br /> FORM A <br /> APPLICAT I O F R ENDORSEMENT <br /> RSE <br /> F PLAN BELIEVED NOT TO REQUIRE APPROVAL <br /> Date <br /> r <br /> To the Planning Board.- <br /> The undersigned, believing that the accompanying plan of his or her property in the Town of Mashpee <br /> does not constitute a subdivision within the meaning of the Subdivision Control Law, herewith subniits <br /> said plan for a determination and endorsement that Planning Board approval under the Subdivision <br /> Control Law is not required. <br /> Name e of Applicant Phone - �+ I <br /> WV <br /> AddressLane. W648 <br /> Owner, if differentappl-i-c-antPhone <br /> Address <br /> Attach copies of a most recent recorded deed and tax bill or 4ssessors'certification. <br /> Engineer or Surveyor .A, . En -ine rin Inc.. Phone 50 -2 - <br /> Address <br /> Deed of property recorded in Barnstable County Registry Book page <br /> r Land Court Certificate of Title No. 155802 <br /> Location-and description of property <br /> Mashpee Assessors Maps and Block Map 54 ,Lots 7 8 - <br /> Signature of Owner or Authorized Representative 2ZCAA ' <br /> Attach written authorization,signed by owner. <br />