249 Buckley Road, Holtsville, NY 11742
Phone (631) 758-9664 www.brookhavenny.gov
Superintendent of Highways
HOLTSVILLE ECOLOGY CENTER
GARDEN PLOT Request Form
Yearly Fee: $35
Make checks payable to:
Town of Brookhaven Highway Department
Must be a Town of Brookhaven resident. Only 1 plot per person.
You are responsible for the plot in its entirety.
Plots are 8’ X 8’ and are available to residents to grow vegetables and flowers. The resident must
provide seeds, plants, gardening tools hoses, etc. A spigot for watering is available. If fencing is to
be used, it must be on the inside of the bed. Parking fees apply. (Resident stickers are available.) If
we do not hear from you, the plot will be re-assigned to the waiting list. You MUST reapply for
plots on a yearly basis.
Name: _________________________________________________________________
Address: _______________________________________________________________
Phone Number(s): _______________________________________________________
Signature: ______________________________________ Date: _________________
Receipt # ____________
Payment: Check # ____________ Credit Card ______ Cash _________
Approved by:___________________ Date: ___________ Plot # _________
click to sign
signature
click to edit
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