Town Of Ashburnham Planning Board
FORM K1
Application to
REQUEST RELEASE OR PARTIAL RELEASE OF COVENANT
Date:__________________________
To: The Planning Board
Town of Ashburnham, Massachusetts
The undersigned herby requests the release of the following ‐
Lot(s) ________________________________________________________ shown on a plan entitled
_____________________________________________________________________________ dated
________________________, from the provisions of a covenant agreement dated
__________________________. Record owner as of _______________________________
Date
____________________________________________________________________________
Name of owner
___________________________________________________________________________________________
Signature of owner
For Planning Board Use Only
Date Received__________________
Fee ______________
Paid: Yes ___ No ___
Comments:
Ashburnham Planning Board
Form K1 – Request for Covenant Release
Adopted January 2008