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HomeMy WebLinkAbout22SUB6- App Rev 121222H:\APPLICATION FORMS\APPs & Guidelines (Each) rev 11-16-2018\Subdivision Resubdivision APP rev 11-15-2018.doc Permit # 22SUB6 Fees $ ______________ Subdivision/Resubdivision Application Assessors Map _______ Lot _______ Acres_________ Zoning District___ ___ # Of lots________ Project address: ____________________________ Subdivision Name ____________________________ Resubdivision only: Name of original Subdivision ________________________________________________________ Date of Commission Approval _______________________________________________________ Property owner name: ____________________________________________________________________ Property owner address: __________________________________________________________________ Applicant name: ________________________________________________________________________ Applicant address: _______________________________________________________________________ Tel # _____________________________________Cell # _______________________________________ Fax # ________________________Email ____________________________________________________ Engineer name: _________________________________________________________________________ Tel # _____________________________________Cell # _______________________________________ Fax # ________________________Email ____________________________________________________ Attorney name: __________________________________________________________________________ Tel # _____________________________________Cell # ________________________________________ Fax # _______________________Email_____________________________________________________ Regulated wetlands  yes  no Public water supply watershed  yes  no Community well system  yes  no Flood Hazard Area  yes  no Flood zone _______________ Municipal water  yes  no Individual well  yes  no Subsurface sewage disposal  yes  no Municipal sewer  yes  no Coastal Management Area  yes  no Ct General Stormwater Quality Permit  yes  no Army Corps of Engineers  yes  no Water diversion permit  yes  no Dam permit  yes  no Subject to a conservation restriction and/or a preservation restriction yes  no Office of State Traffic Commission (OSTA )Permit yes  no DOT encroachment permit yes  no Waiver(s) requested yes  no Regulation section(s) _____________ Erosion & sediment control bond $_________________ Performance/Road bond $_________________ Subdivision/Resubdivision Application Page 1 of 2 26-00A 2R40 Crowley Subdivision137 Gay Hill Road John M. & Lynette S. Crowley 137 Gay Hill Road, Uncasville, CT 06382 137 Gay Hill Road, Uncasville, CT 06382 John M. & Lynette S. Crowley David L. Cooley, P.E. - DLC Engineering Services, LLC 860-966-5528 dlcengineeringservicesllc@gmail.com 5.46 860-885-4763 jcrowley27@sbcglobal.net 23   December 6, 2022    Ms. Liz Burdick  Director ‐ Department of Land Use & Development  Town of Montville  310 Norwich‐New London Turnpike  Uncasville, CT  06382    SUBJECT:  CROWLEY SUBDIVISION, 137 GAY HILL ROAD, UNCASVILLE, CT    Ms. Burdick,    Let this correspondence serve as my authorization, as property owner of 137 Gay Hill Road and the  applicant of the Crowley Subdivision, to allow Brian Florek, L.S. of Florek Surveying, LLC and/or David  Cooley, P.E. of DLC Engineering Services, LLC to act in my stead as my representatives for the subject  subdivision application and all other associated administrative or regulatory proceedings. Unless  otherwise required by the Town of Montville.     Thank you. Let me know if there are any further questions or concerns.     Sincerely,    John Crowley   John Crowley  Property Owner – 137 Gay Hill Road/Applicant