HomeMy WebLinkAboutDeed Restriction Application - Not Required O�•'rq�4 ���`�� � `'' ��C �
� ' -� :�a TOWN O YARMOUTH
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�"'r,,,�,�w��'�d' Telephon� (50H) 39H-Z231. Ext. ?41 — Fax (50H) 394-236� ,
B O A R D O F H E A L T H
APPLICATION FCS2 LJITRATE LOADING D� RFSTRICTION
The information requestion below must be accurate and completed in full to
ensure the deed restriction can be completed properly and in a timely manner.
1.) Town Assessors book dated 1994: � /, � ��
N1ap �3� , Lot # �- , Address � i/�" ��'�
2.) The lot indicated above is s own on a plan of land entitled:
� C��G L� S �%� � ( ► dated t` ���'
The plan of land for the lot above is recorded at the Barnstable
County Registry of Deeds on the Deed Book � , Page�.
3.) The property deed is recorded at the Barnstable County Registry of
Deeds on the Deed Book��, Page ;�e7 , for the lot indicated above.
4.) The nitrate loading calculations have been prepared by:
, and dated
5.) The engineered plan has been prepared by ,
dated
_ ' 6.) Board of Health approval date:
7.) The lawn area is limited to �Od square feet.
8. ) The number of bedrooms limited to Z
9.) Name of Owner: �'6� i 2-- f✓ ``� ' �,
2-�
Address of Owner: 'D dz
_ ���d
3�y .�4��
The required information supplied to this department for the application of a
nitrate loading deed restriction is correct as shown above.
� �
Applicant �C����� L��� , Date
2/95
�� Printed on
�( Recycied
�,!� i aper