Form E

UNDER CONSTRUCTION

FORM E

CERTIFIED LIST OF ABUTTERS

SUBDIVISION NAME:                                                                DATE:                                   

The undersigned, being an applicant for approval of a Definitive Plan of a proposed subdivision entitled

                                                                                                                                                         _____

Submits the following sketch of the land in the subdivision listing the names of the adjoining owners and all other owners of land within three hundred feet (300’) of the boundaries of the land shown on the plan and indicating the address of each on the sketch or in a separate list.

                                                                                                                                                                     Signature of Applicant

                                                                                                                                                                    Address

                                                                                                                                               , Massachusetts

                                                                                                                                               , 20________

To the Planning Board of the Town of Middleboro:

This is to certify that at the time of the last assessment for taxation made by the Town of Middleboro, the names and addresses of the parties assessed as adjoining owners to the parcel of land shown above and within three hundred feet (300’) thereof, were written above, except as follows:

                                                                                                                                                                  Clerk for the Middleborough Board of Assessors