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APP w CZC
Zoning Permit #: Map Lot "5!� Zone s 7' �S Expiration Date: Town of Montville ZONING PERMIT PROPOSED PROJECT: G - D " $ I 0 1— 0 'l Property Owner: ,�� Applicant: w• R. /4//Ci. Co. Applicant Address: 48 /VOR£41/&1 New h'`•A 7-frit-if- k,, G Phone#g( 6-9r-- .r? Fax#1/0 YJ 6!' Email: 1 1 •44) ize-i,co, eves, Provide the following: l Copy of plans drawn to scale of at least 1" = 40' ShoWinf;: dimensions of lot, size and location of existing, proposed structures, driveways, sanitary facilities and water supply, parking facilities, and adjacent streets; distances of proposed structures from property lines and wetlands. (A copy of plan prepared by a Connecticut Registered Land Surveyor may be required). The proposed project specified above shall not be authorized until an actual Certificate of Zoning Compliance is issued by the Commission or its appointed agent. The Owner/Agent is responsible for and agrees to: 1. Notify the Commission or its appointed agent of any alteration in the plans. 2. Contact the Zoning Officer (860-848-6753) at least 24 hours before construction begins and upon completion of project. 3. An E&S bond may be required prior to compliance sign off and held for one (1)year from this date. I hereby certify that the.information provided is true and correct and further attest the proposed project is authorized by the owner in fee and I am authorized to make application for a permit for such described work. Own Agent Si nature �G(>�=e �- � � Date: �6/d'-d /7 Applicant Signature RC1 ----� �L¢ ` Date: A,/Zv /7 .�� ; 6/KI,�ob Oil( 13 �' mmissio Agent Date Certificate of Z ing Compliance(CZC)Date OFFICE USE ONLY Cash / Check #:.��I�S 7' YES l N/A Site Plan ©/ Wetlands Permit ❑ Has a Variance Ever Been Granted For This Property? ❑ ems/ Has Bond Been Filed? ❑ ®/ H IForms TemplateslZoninglZoningPermit.docll/22/20162:51PM