HomeMy WebLinkAbout23SITE7 69 Fitch Hill Rd - App 6052023
H:\APPLICATION FORMS\APPs & Guidelines (Each) rev 11-16-2018\Site-SP APP rev 11-15-2018.docx
Town of Montville Planning & Zoning Commission
Site Plan or Special Permit Application
Site Plan Number ____________ Plan Date ________________
Revision ________________
Special Permit Fee paid ____________ Revision ________________
____________________________________________________
Assessors Map ___________ Lot ______________
Project Address _______________________________________________________________
Name of Applicant ____________________________________________________________
Address of Applicant __________________________________________________________
Project Name ________________________________________________________________
Tel #___________________________________Cell#________________________________
Fax #_____________________Email_____________________________________________
Name of Property Owner _______________________________________________________
Name of Attorney ____________________________________________________________
Tel #___________________________________Cell#________________________________
Fax #_____________________ Email_____________________________________________
Name of Engineer ____________________________________________________________
Tel #___________________________________Cell#________________________________
Fax #_____________________ Email_____________________________________________
__________________________________________________
Zoning District ____________ Lot Size ______________ Total Acres___________
Yes No Regulated Wetlands Acreage __________ Permit Date______________
Yes No Flood Plain Flood Hazard Area ___________________________
Yes No A-2 Survey Name of Surveyor ____________________________
Building size __________s.f. Building height ______________________________
Number of acres to be disturbed _________________________________________________
Applicable Zoning Regulation(s)_________________________________________________
Project description ____________________________________________________________
___________________________________________________________________________
____________________________________________________
This project will use:
Septic system Municipal sewer
Individual well Public water supply well SCWA well Municipal water
Yes No This project is located in a Public Water Supply Watershed
Yes No This project has received approval from the Uncas Health District
Yes No This project has received approval from the appropriate Water Authority
** Attach Copy of All Approvals
Page 1 of 2
Site Plan /Special Permit Application
x
062-036-000
69 Fitch Hill Road
Andrew Petrowski
37 Cove Road, Uncasville, CT 06382
860-608-9179
abexcavation@yahoo.com
same
Green Site Design, LLC - Ellen Bartlett
860-917-6597
ebartlett@greensitedesignllc.com
LI 33.9 33/9
8.9
AE & X
James Bernardo
30 ft.
19,920
6,000 &19,920
10 acres
12.2.2 & 12.2.5
an application for multiple warehouse/office space buildings
H:\APPLICATION FORMS\APPs & Guidelines (Each) rev 11-16-2018\Site-SP APP rev 11-15-2018.docx
Yes No This project requires a State General Stormwater Quality Permit.
Registration # _______________
Yes No This project requires a permit from the Army Corps of Engineers.
Yes No This project requires a Water Diversion Permit.
Yes No This project requires a Dam Permit.
Yes No This property is subject to a Conservation Restriction and/or a
Preservation Restriction. If yes, attach a copy of certified notice.
Yes No Drainage calculations submitted:
Date _________ Rev. date _________ Rev. date _________
______________________________________________________________________________
Yes No This project requires a OSTA (Office of State Traffic Commission)
Permit.
Yes No This project requires a DOT Encroachment Permit.
Yes No The plan has been submitted to the DOT District 2 Office.
Number of parking spaces provided _______________
Number of vehicle trips per day generated by this project ______________
Yes No A determination of applicability of of the following Zoning Regulations
Sections ______________________________________________
______________________________________________________
Signature of Applicant ____________________________________________ Date __________
Signature of Owner ___________________________________________ Date __________
______________________________________________________
OFFICE USE ONLY
Review Date Sent Date Received
Town Engineer
Uncas Health District
Fire Marshal
Building Official
Mayor
WPCA
DOT District 2
N.L. Water
Other
Date of Receipt ______ Date of Public Hearing ______ Date Hearing Closed _________
Date of Extension #1 ______ Date of Extension # 2 ______ Terminal Date ___________
Site Plan /Special Permit Application
Page 2 of 2
5/25/23
78
156