Town Seal
NOTICE OF LOT MERGER
The Town of Holderness, New Hampshire
NOTICE OF LOT MERGER
TOWN OF HOLDERNESS PLANNING BOARD

Pursuant to RSA 674:39-a, the owner(s) of the following described lots located in the Town of Holderness, Grafton County, New Hampshire, has merged them for municipal planning and assessment purposes.  The following described lots can not be conveyed separately, without subdivision approval.

OWNERS OF RECORD:

______________________________________________________________________

LOTS TO BE MERGED:
Tax Map#                Lot #           Registry Book & Page                    Registry of Deeds
                                                                                Plan # if applicable
________                ______  _____________________           _______________

________                ______  _____________________           _______________

The consent(s) of person(s) holding mortgages, liens, encumbrances or other interests in said lots or parcels, which are attached hereto, are incorporated in this Notice.  

IN WITNESS WHEREOF,
Have executed this Notice of Merger this _______ day of ______________, _____.

_______________________         ____________________________
    Witness                                            Owner, Trustee
_______________________         ____________________________
    Witness                                            Owner, Trustee
_______________________         ____________________________
    Witness                                            Owner, Trustee

Copies of each property deed must be attached to this notice to be considered by the Planning Board.

STATE OF NH
COUNTY OF

The foregoing instrument was acknowledged before me this _____ day of ___________, ________.

                                                        Before me,
                                                        __________________________
                                                        Notary Public/Justice of Peace
                                                        My Commission Expires

The merger of the foregoing lots was approved by the Holderness Planning Board pursuant to RSA 674:39-a on ___   day of _____________, ________.
                        
                                                        _______________________________
                                                        Chairman, Holderness Planning Board

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