City of Woburn, Massachusetts WOBURN CITY COUNCIL City Hall 10 Common Street Woburn, MA 01801 Filing Fee $200.00 PETITION FOR SPECIAL PERMIT 1. Petitioner: ________________________________________________________________________ Address: _________________________________________________________________________ _______________________________________________ Telephone: _______________________ 2. Landowner: _______________________________________________________________________ Address: _________________________________________________________________________ _______________________________________________ Telephone: _______________________ 3. Property Location: _________________________________________________________________ 4. Zoning District: _________________________ 5. Section(s) of Woburn Zoning Code under which Special Permit is required (See Section 5.1 Table of Use Regulations: __________________________________________________________________ 6. Statement of purpose and description of proposal including the section of Woburn Zoning Code section under which you are applying (attach plans and additional documentation to this Petition): 7. Signature of Petitioner: ________________________________________ Date: _____________ 8. Signature of Landowner: _______________________________________ Date: _____________ (revised 6/24/2014) American LegalNet, Inc. www.FormsWorkFlow.com