HomeMy WebLinkAbout23IWC10-958 Route 163 - Wetlands Application
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Town of Montville Inland Wetlands Application Permit# ___________________Check #_________
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 SUBMIT FOURTEEN (14) COPIES OF THE
APPLICATION AND FOURTEEN (14) COPIES OF ANY OTHER DOCUMENTS AT LEAST FIVE
BUSINESS DAYS PRIOR TO THE MEETING.
I. Applicant Information
Name________________________________
Address__________________________________________
Tel #_________________________________Cell #____________________________________
Fax #__________________________Email___________________________________________
Attach a Written Consent to the proposed activity from the owner if applicant is
not the owner
II. Owner Information
Name________________________________ Address__________________________________
Tel #_________________________________Cell #____________________________________
Fax #__________________________Email___________________________________________
III. Engineer Information Contact_____________________________________
Firm________________________________ Address___________________________________
Tel #_________________________________Cell #____________________________________
Fax #__________________________Email___________________________________________
IV. Attorney Information Contact_____________________________________
Firm________________________________ Address___________________________________
Tel #_________________________________Cell #____________________________________
Fax #__________________________Email___________________________________________
V. Property Information
Address of Proposed Activity_______________________________________________________
Assessor’s Map and Lot Number_____________________________________________________
Land Records /Deed Volume: _________Page:___________ Acreage of Property______________
Zoning _______________
Provide a List of the Names and Mailing Addresses of Adjacent Property Owners (Attach Sheet)
Inland Wetlands Application
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VI. Wetlands and Watercourse Information
Total Acreage of Wetlands on the site____________________ acres
Wetland Disturbance Area_____________________________ sq ft
Upland Review Disturbance Area ________________________sq ft
Name of Soil Scientist____________________________________
Linear Feet of Watercourse Disturbance_____________________ ft
Creation of New Wetlands________________________________ sq ft
VII. Project Description
Activity will involve (Check all that apply)
See attached checklist of items that are to be included on Plan and supplemental data.
A) Attach a Detailed Plan of the Proposal and indicate Plan Title and Date.
_____________________________________________________________________________________
_____________________________________________________________________________________
________
B) Provide Brief Description of the Proposed Project on separate piece of paper. Instructions attached.
C) List Titles and dates of all documentation which will be included and submitted with this application
and attach to application. Documents should include, but are not limited to; Project Proposal, Soil
Scientist Reports, and Drainage Calculations.
VIII. Other Information
1. Does the application involve an activity in a regulated area that is within 500 ft of another
municipality?
- If YES, then a copy of the application and all material is to be submitted to said Town and a
copy of the transmittal form is to be provided to the Commission.
2. Is the property located within a Flood Hazard Area?
-If YES, then please provide additional material showing the location of the area.
3.
- If YES, then a copy of the application and all material is to be submitted to the State Department
of Health as well as the appropriate Water Company. See attached instructions for the
Notification Process for the State Health Department. A copy of the transmittal forms shall be
provided to the Commission.
Inland Wetlands Application
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