Get MA WPA Form 8A 2014-2023

Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands WPA Form 8A Request for Certificate of Compliance DEP File Number Provided by DEP A. Project Information Important When filling out forms on the computer use only the tab key to move your cursor do not use the return key. 1. This request is being made by Name Mailing Address City/Town State Zip Code Phone Number Applicant Dated Upon completion of the work authorized in an Order of Conditions the property owner must request a Certificate of Compliance from the issuing authority stating that the work or portion of the work has been satisfactorily completed* The project site is located at Street Address Assessors Map/Plat Number Parcel/Lot Number The final Order of Conditions was recorded at the Registry of Deeds for Property Owner if different County Book Page the work regulated by the above-referenced Order of Conditions has been satisfactorily completed* the following portions of the work regulated by the above-referenced Order of Conditions have been satisfactorily completed use additional paper if necessary. the above-referenced Order of Conditions has lapsed and is therefore no longer valid and the work regulated by it was never started* wpaform8a*doc rev* 5/29/14 Page 1 of 2 6. Did the Order of Conditions for this project or the portion of the project subject to this request contain an approval of any plans stamped by a registered professional engineer architect landscape architect or land surveyor Yes If yes attach a written statement by such a professional certifying substantial compliance with the plans and describing what deviation if any exists from the plans approved in the Order. No B. Submittal Requirements Requests for Certificates of Compliance should be directed to the issuing authority that issued the final Order of Conditions OOC. If the project received an OOC from the Conservation Commission submit this request to that Commission* If the project was issued a Superseding Order of Conditions or was the subject of an Adjudicatory Hearing Final Decision submit this request to the appropriate DEP Regional Office see http //www. mass. gov/eea/agencies/massdep/about/contacts/find-the-massdep-regional-officefor-your-city-or-town*html. Project Information Important When filling out forms on the computer use only the tab key to move your cursor do not use the return key. 1. This request is being made by Name Mailing Address City/Town State Zip Code Phone Number Applicant Dated Upon completion of the work authorized in an Order of Conditions the property owner must request a Certificate of Compliance from the issuing authority stating that the work or portion of the work has been satisfactorily completed* The project site is located at Street Address Assessors Map/Plat Number Parcel/Lot Number The final Order of Conditions was recorded at the Registry of Deeds for Property Owner if different County Book Page the work regulated by the above-referenced Order of Conditions has been satisfactorily completed* the following portions of the work regulated by the above-referenced Order of Conditions have been satisfactorily completed use additional paper if necessary. .