Abutters List Request Form

"*" indicates required fields

MAP

LOT

Property Address

Street Address Address Line 2 City State ZIP Code

Distance Required from Parcel # Listed Above*

500

300

100

Property Owner

Property Owner's Mailing Address

Street Address Address Line 2 City State ZIP Code

Property Owner's Telephone

Requestor's Name (if different from Owner)

Requestor's Mailing Address

Street Address Address Line 2 City State ZIP Code

Requestor's Telephone

Requestor's Email*

Town Report – January 23