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Home My WebLink About10x16 Shed 1999 Town of Montville Building Department 310 Norwich-New London Tpke. , Uncasville, Ct . 06382 Tel . 848-7166 ***************************************************************************** APPLICATION FOR BUILDING PERMIT OR TRADES PERMIT, Please fill out completely Owner: . 014,✓ ? )44 ev ii-;14,1 Mailing Address : ) ('V T4X A-C ,,L City: b1,t/iAlviti{ State: GT Zip Code L2&). 2 Tel : g-W"'4344/ Job Location: Map/Block/Lot: Contractor: Mailing Address : City: State: Zip Code: Tel : ****************************************************************************** Stick Built : Modular Home: Manufactured Home: Commercial : Addition: Garage: _ Car Port : Shed: .X Remodeling: Roofing: Siding: Fireplace: Chimney: Windows : Pool : Demolition: Plumbing: Heating: Electrical : Air Conditioning: Gas : Patio: Porch: Deck: Retaining Wall : New: Repair/Replacement: Job Discription/Materials used: ji;X/G- L5Yed Size: Type of Heat : Fireplace: No. of Stories : No. Rooms : Breezeway: No. Baths : Garage: Use: I hereby certify that the proposed work will conform to the Basic Building Code and all other Codes as adopted by the State of Connecticut, and the Town of Montville and further attest that the proposed work is authorized by the owner in fee and that I am authorized to make application for a permit for such work as described abo e. Owner/Agent Signature !/ Date c;.2� "�I.�/� If signed by Contractor, type of license/registration & No: ****************************************************************************** Building Department Use Only Construction Value Fee Building z/oo 16— Plumbing Heating Electrical Air Cond. Other Certificate of Occupancy /6-- Plan Review Fee X40 State Education Fee .3y Total Fees 2721-) :,,) __4_. Cash Check { ;.,, 6 ,s' ZONING PERMIT ZONING PERMIT NUMBER 99 i99 OR ON/A EXPIRATION DATE 9c2- q9 PROPERTY LOCATION 9/64 Ove e!l MAP LOT PROPERTY OWNER Jai,/ 3 J69,��jti 64/-1} CONTRACTOR CONTRACTOR LICENSE# CONTACT ADDRESS TELEPHONE ZONE /C�D LOT AREA , `�7 PERMIT REQUEST Shed ) bac 1I, IT IS THE APPLICANT'S RESPONSIBILITY TO FURNISH THE FOLLOWING INFORMATION: A SKETCH, OR PROVIDE TWO COPIES OF PLANS DRAWN TO A SCALE OF AT LEAST 1" = 40' SHOWING: DIMENSIONS OF THE LOT, THE SIZE, AREA, AND LOCATION OF EXISTING, PROPOSED, PRINCIPAL AND ACCESSORY STRUCTURES, DRIVEWAYS, SANITARY FACILITIES AND WATER SUPPLY, PARKING FACILITIES, AND ADJACENT STREETS; DISTANCES OF PROPOSED STRUCTURES FROM PROPERTY LINES AND WETLANDS. A PLAN PREPARED BY A CONNECTICUT REGISTERED LAND SURVEYOR MAY BE REQUIRED. THE PROPOSED USE SPECIFIED ABOVE SHALL NOT BE AUTHORIZED UNTIL AN ACTUAL CERTIFICATE OF COMPLIANCE IS ISSUED BY THE COMMISSION OR ITS APPOINTED AGENTS. SKETCH PLAN OR GRADING PLAN DYES ❑N/A HEALTH DISTRICT APPROVAL OYES tgNIA STATE HIGHWAY PERMIT OYES ( jN/A WETLANDS PERMIT OYES ON/A HAS A VARIANCE EVER BEEN GRANTED FOR THIS PROPERTY OYES /ONO HAS BOND BEEN FILED OYES O INIA FEE 0 CASH ❑ CHECK# ❑ N/A THE APPLICANT IS RESPONSIBLE FOR AND AGREES TO: 1. ADHERE TO ALL THE APPLICABLE REQUIREMENTS OF THE ZONING REGULATIONS. 2. FURNISH ALL NECESSARY INFORMATION AND DOCUMENTATION TO PROCESS APPLICATION. 3 NOTIFY THE COMMISSION OR ITS APPOINTED AGENT OF ANY ALTERATION IN THE PLANS. 4. CALL FOR FINAL INSPECTION AND REQUEST CERTIFICATE OF COMPLIANCE BEFORE ISSUANCE OF C.O. APPLICANTS SIGNATURE v DATE: o7 ----(A26-CAL4 - 64-A-g-c/ V-2-A"C/ COMMISSION AGENT DATE CERTIFICATE OF COMPLIANCE DATE THIS SIGNED PERMIT AUTHORIZES THE APPLICANT TO PROCEED TO THE BUILDING DEPARTMENT FOR ANY REQUIRED PERMITS CONTACT THE ZONING OFFICER (848-8549) AT LEAST 24 HOURS BEFORE CONSTRUCTION BEGINS TO ALLOW ZONING OFFICER TO INSPECT LOCATION. REV. 6/29/99 /CO -Hir-/` ZONING PERMIT ZONING PERMIT NUMBER 99-/q9 OR ON/A EXPIRATION DATEi7/� PROPERTY LOCATION It .ThI � 21/e b- ? MAP LOT / 5 PROPERTY OWNER JO\14/ 7 )6,40/1.1 r)y� CONTRACTOR CONTRACTOR LICENSE# CONTACT ADDRESS TELEPHONE . ZONE K c:2D LOT AREA ,j PERMIT REQUEST S -),e ) (?n ill IT IS THE APPLICANT'S RESPONSIBILITY TO FURNISH THE FOLLOWING INFORMATION: A SKETCH, OR PROVIDE TWO COPIES OF PLANS DRAWN TO A SCALE OF AT LEAST 1" = 40' SHOWING: DIMENSIONS OF THE LOT, THE SIZE, AREA, AND LOCATION OF EXISTING, PROPOSED, PRINCIPAL AND ACCESSORY STRUCTURES, DRIVEWAYS, SANITARY FACILITIES AND WATER SUPPLY, PARKING FACILITIES, AND ADJACENT STREETS; DISTANCES OF PROPOSED STRUCTURES FROM PROPERTY LINES AND WETLANDS. A PLAN PREPARED BY A CONNECTICUT REGISTERED LAND SURVEYOR MAY BE REQUIRED. THE PROPOSED USE SPECIFIED ABOVE SHALL NOT BE AUTHORIZED UNTIL AN ACTUAL CERTIFICATE OF COMPLIANCE IS ISSUED BY THE COMMISSION OR ITS APPOINTED AGENTS. SKETCH PLAN OR GRADING PLAN nDYES ON/A 5�+ HEALTH DISTRICT APPROVAL DYES RN/A STATE HIGHWAY PERMIT DYES 4N/A WETLANDS PERMIT OYES RN/A HAS A VARIANCE EVER BEEN GRANTED FOR THIS PROPERTY DYES ,JNO HAS BOND BEEN FILED OYES GIN/A FEE 0 CASH ❑ CHECK# ❑ N/A THE APPLICANT IS RESPONSIBLE FOR AND AGREES TO: 1. ADHERE TO ALL THE APPLICABLE REQUIREMENTS OF THE ZONING REGULATIONS. 2. FURNISH ALL NECESSARY INFORMATION AND DOCUMENTATION TO PROCESS APPLICATION. 3. NOTIFY THE COMMISSION OR ITS APPOINTED AGENT OF ANY ALTERATION IN THE PLANS. 4. CALL FOR FINAL INSPECTION AND REQUEST CERTIFICATE OF COMPLIANCE BEFORE ISSUANCE OF C.O. APPLICANTS SIGNATURE �/Yl� DATE: 0, —112,e-caL4 V-i-/9c( - —4(est,6! COMMISSION AGENT DATE CERTIFICATE OF COMPLIANCE DA THIS SIGNED PERMIT AUTHORIZES THE APPLICANT TO PROCEED TO THE BUILDING DEPARTMENT FOR ANY REQUIRED PERMITS CONTACT THE ZONING OFFICER (848-8549) AT LEAST 24 HOURS BEFORE CONSTRUCTION BEGINS TO ALLOW ZONING OFFICER TO INSPECT LOCATION. 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