HomeMy WebLinkAboutAPP Th
Town of Montville Inland Wetlands Application #a9C7 l.k)C- -7
et,e,
APPLICANT INSTRUCTIONS: All applicants must complete this application form.The Commission will notify
the applicant of any additional information that may be required and will schedule a Public Hearing if necessary.In
addition to the information required,the applicant may submit other supporting facts or documents which may assist
the Commission in its evaluation of this proposal.PLEASE SlUBMIT NINE COPIES OF THE APPLICATION
AND NINE COPIES OF ANY OTHER DOCUMENTS AT LEAST FIVE BUSINESS DAYS PRIOR TO IHE
MEETING.
I. Applicant Information
Name DerN AU> g TZ.
Address /S.7 10 Do ' /2- aele.DA-Lis„e-ro 6 Z 70
Tel# g - 5'7 /S ceii#
Fax# Email
•
Interest in Property 0 Owner 0 Option Holder 0 Developer 0 Harvester Other
)7 Attach a Written Consent to the proposed activity from the owner if applicant is
not the owner >iiRequired Li Not Required
II. Owner Information
Name gEITY I TZ.,rP_iarroaddress /� 7 D Dexfi-C I?_1) eA(14..j. Clr-063
Tel# Co- 5?•-- Cell# — Z - ?73.Z
Fax# • Email
M.Engineer Information Contact slrevAJ A /2744.frea.› L-
Firm STWZ yn4 A-C. Address 7'i C1._Aeogga4ey, pew..4 12 )4, e..14);CA._o)Cir 063
o
Tel# g 5.57-li Y '( Cell# 860-z6?-/g77
Fax# Email te-it)4 Ri en).1 e0 a4 AIL c114
IV.Attorney Information Contact
Firm Address
Tel# Cell#
Fax# Email
V.Property Information
Address of Proposed Activity /5-7 Doc/iL 69 (CD el CZ. C-r-
Assessor's Map and Lot Number in APS 7 to-r 0/ 0- 000
Land Records/Deed Volume: - aZ Page: 7C2_ Acreage of Property C 2 3
Zoning R/2.0
II Provide a List of the Names and Mailing Addresses of Adjacent Property Own
ii
JUL 8 2020
By
Inland Wetlands Application
Page 1 of 3
H:"APPS.Forms,Tempiatcs\APPs&Guidelines(Erichl rev I 1-16-20 I 8\IWC A PP rev I I-1-201&cloc-
• •
4. Does the application require approval from Uncas Health District? A'es ONo
- If YES,then a copy of the approval is to be provided to the Commission.
5. Does the application require approval from the Public Works Dept? DYes No
( -If YES, then a copy of the approval is to be provided to the Commission.
i
, 6. Does the application require approval from the Town of Montville WPCA? DYes ko
- If YES, then a copy of the approval is to be provided to the Commission.
7. Does the application require permits from the following agencies?
Submission Info
Army Corps of Engineers DYes '7*o Date
Department of Environmental Protection DYes X.No Date
Department of Transportation DYes X4•10 Date
- If YES,then a copy of the application and all material is to be submitted to said Agency
and a copy of the transmittal form is to be provided to the Commission.
8. Does this permit require a State Water Diversion Permit? DYes gro
9. Does this permit require a State Dam Permit? DYes ›ijo
10. Is this property subject to a Conservation Restriction arid/or a Preservation Restriction?
-If YES, attPch a copy of certified notice. DYes ' No
11. If the application is a renewal or modification of an existing permit, is a copy of the original
approval included in the documentation package? Piii- DYes LINO
The undersigned applicant hereby consents to necessary and proper inspections of the above mentioned
property by agents of the Montville Inland Wetlands Commission at reasonable times, both before and
after the permit in question ,i,-e I u.: ted by the Commission.
Name _..- -f4,V e "Pse--or" Date 07 e>6 26
0
Property Owner if other than Applicant0 wilialL.viergli4k , C.3-.$-- - Date 0 1 -D tc" -2-C-)
Inland Wetlands Application
Page 3 of 3
.::-k ,,,,,. ,,.-,ii:...::,v.-. i -if.-jf..:,: t.... ,P; .J*. !!-• :.''SS-1-;,
•
tttl!
Montville Town Hall
Inland Wetlands Commission
310 Norwich-New London Turnpike
Uncasville, CT 06382
Re: Inland Wetlands Permit Application
157 Doyle Road Unit D
(Assessor's Map 57 Lot 010-00D)
Dear Mr. Chairman,
Please be advised that I, Betty K. Raitz is the owner cif proltett y located al #1
Doyle Road Unit D (Assessor's Map 057 Lot 010-DOD) and Donald liait7 it t.tlyllic;titt
for an Inland Wetlands Permit Application for the above mentioned property. Wc. the
owner and applicant do both hereby consent to the proposed activity and do gt ant
authority to Steven R. Marien, LS of Star Surveying. LLC to act on my hchall°with
respect to an application for the Inland Wetlands Permit Application for the cel tesairl
property.
Sincerely.
Betty K.
r;.
r��a.
41) 0 �
LIST OF DOCUMENTS
TOWN OF MONTVILLE INLAND WETLANDS APPLICATION
Applicant: Donald Raitz
Mailing Address: 157 D Doyle Road
Oakdale, CT 06370
Subject Property: 157 D Doyle Road
Montville Assessor's Map 57 Lot 010-OOD
1. Town of Montville Inland Wetlands Application.
2. Town of Montville Inland Wetlands Application Checklist.
3. List of names and mailing addresses of adjacent property owners.
4. Letter of consent and authorization for the said application.
5. Letter from Joseph Theroux, Certified Soil Scientist.
6. Project Description
7. Statewide Inland Wetlands & Watercourses Activity Reporting Form.
8. Set of plans: BOUNDARY AND TOPOGRAPHIC SURVEY PLAN &
SANITARY REPAIR PLAN PREPARED FOR DONALD RAITZ PROPERTY
OF BETTY K. RAITZ LOCATED AT 157 DOYLE ROAD,UNIT D,
AKDALE CONNECTICUT DATE: JULY 6 2020 SCALE: 1
MONTVILLE (OAKDALE), ,
INCH= 10 FEET SHEET 1 AND 2 OF 2 PREPARED BY STAR SURVEYING,
LLC
9. Check for$110.00 to Town of Montville. IV I i 5
pCCC [1
J U L 8 2020
By