HomeMy WebLinkAboutAPP ZONING PERMIT
IT IS THE APPLICANT'S RESPONSIBILITY TO FURNISH THE FOLLOWING
INFORMATION:
PROPERTY LOCATION ,Mi r�\P�C.��LP1aj1 LCA f�Q� MAP j LOT 1
PROPERTY OWNER 1 (�1 1a �1\P 3 1`1C i5 1�4 Ste,x IQ-�rf
CONTRACTOR {XC�- Pat CONTRACTOR LICENSE#
CONTACT ADDRESS TELEPHONE
ZONE g..4)-0 LOT AREA Of CI STRUCTURE AREA HEIGHT
� ����
NATURE OF REQUEST/PROPOSED USE g A �V(..)1 1.Dt.1IJ��
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.
Office use only
YES N/A
SKETCH PLAN OR GRADING PLAN PG"-S- ❑
HEALTH DISTRICTIWPCA APPROVAL 0 ❑
STATE HIGHWAY PERMIT ❑ ❑
WETLANDS PERMIT ❑
HAS A VARIANCE EVER BEEN GRANTED FOR THIS PROPERTY ❑
HAS BOND BEEN FILED ❑ ❑
FEE ❑ CASH/CHECK# ❑
ZONING PERMIT NUMBER x 2- 2 3 OR N/A EXPIRATION DATE h I �1� 1 Q 3
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. CONTACT THE ZONING OFFICER (848-8549) AT LEAST 24 HOURS BEFORE CONSTRUCTION BEGINS AND
UPON COMPLETION OF PROJECT TO ALLOW ZONING OFFICER TO INSPECT LOCATION.
APPLICANTS SIGNATURE --- F� DATE: 1151 I U
..v2,(4..J.) ' ' • �� DATE P/C/G ? aADATE /974-05 --
COMMISSION
4-/6 --COMMISSION AGENT
CERTIFICATE OF COMPLIANCE
THIS SIGNED PERMIT AUTHORIZES THE APPLICANT TO PROCEED TO THE BUILDING DEPARTMENT FOR ANY REQUIRED PERMITS
THE SIGNED CERTIFICATE OF COMPLIANCE IS NEEDED PRIOR TO A CERTIFICATE OF OCCUPANCY BEING ISSUED BY THE BUILDING
INSPECTOR
REV. 6/29199