Request for State-listed Species Information
Please complete this form to request state-listed species information from the Natural Heritage &
Endangered Species Program for a particular location (please submit only one project per form).
Fee: $50.00, Payable to Comm. of MA – NHESP (as required in 321 CMR 10.17(3))
No fee required if request is for conservation purposes or habitat management and you are a non-profit
conservation group, government agency or are working with a government agency.
Requestor Information
Name: Affiliation:
Address:
City: State: Zip Code:
Daytime Phone: Ext. Email address:
Project Information
Project or Site Name:
Location: Town:
Name of Landowner or Project Proponent (if different from Requestor):
Acreage of the Property:
Description of Proposed Project and Current Site Conditions: (If necessary attach additional sheet)
Required: Enclose a map with the site location clearly marked and centered on the page.
Please mail this completed form, a topographic map, and fee (if applicable) to the above address, Attn:
Regulatory Review.
If no fee is required, you can email the information to natural.heritage@state.ma.us
.
A written response will be returned within 30 days of receipt of all information required.
