Form A Submission Checklist for Special Permit Applications Applicant: ______________________________ Contact Person: _________________ Tel #: ______________ Project Description and Address: _______________________________________________________________ Date of Application, as stamped by the City Clerk _________________ Note: this checklist must be included with the application for Special Permit, per Section 11.4 of the 1985 Woburn Zoning Ordinance, as amended. The applicant shall submit a written explanation for any omitted checklist item(s). For additional information on any checklist item listed below, refer to the Sec. 11 – Special Permits and Variances of the 1985 Zoning Ordinance, as amended. Information Required Applicant’s Initials Staff Initials 1. Name and address of the applicant. 2. Statement certifying ownership of the premises involved, or evidence that the applicant has permission of the owner to make such application. 3. Legal description of, and street address if there is one, of the location of the premises. 4. Plans shall show the following: a.) existing and proposed buildings; b.) existing and proposed contour elevations in two foot increments; c.)parking area and utilization; d.) driveways and access to site; e.) facilities for vehicular and pedestrian movement; f.) drainage system and calculations; g.) the location, capacity, and projected usage of facilities; h.) landscaping, including trees to be retained and removed; i.) exterior lighting; j.) loading and unloading facilities; k.) provision for refuse removal. 5. Other information, as may be required: a.) projected traffic volumes and impact; b.) evidence as to the status of all permit applications to other local, state and federal agencies concerning the project; c.) other information as may be necessary to determine compliance with the provisions of this ordinance. d.) a list of abutters within 300 ft. from any property line, as certified by the Board of Assessors; e.) tax liens on property. Applicant’s signature: ________________________________________________ Date: __________________ Note: If any of the above items are missing or found deficient in any way, the City Council may choose to consider the submission incomplete, and as such, the application may be subject to denial. FOR CITY CLERK USE: Reviewed and approved as suitable for a public hearing by: _________________________ Date: _________________ COMMENTS: American LegalNet, Inc. www.FormsWorkFlow.com