HomeMy WebLinkAboutmcparland mzc form REV pdfMassachusetts Department of Environmental Protection
Chapter 91 Waterways Water-Dependent, Nonwater Dependent, Amendment Application
Municipal Zoning Certificate
Zoning.doc Rev_1021 Page 1 of 1
Note to Permittee: This form should be submitted, with the top portion completed, to the municipal clerk or zoning
official along with the complete application and project plans.
Name of Permittee
Project Address Name of Waterway City/Town
Description of project and use or change in use (this field is not limited to the one line shown).
To be completed by the municipal clerk or other municipal zoning official responsible for administering zoning
ordinances and by-laws.
“I hereby certify that the project described above and more fully detailed in the Permittee’s Waterways License
application and plans is not in violation of local zoning ordinances and/or by-laws.”
Print Name of Municipal Zoning Official Date
Signature of Zoning Official Title City/Town
Stephen M & Beth F McParland, Trustees
McParland Family 2014 Revocable Trust