Application To Request Release Or Partial Release Of Covenant

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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 

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