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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
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Site Plan /Special Permit Application