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Home My WebLink About24SITE12 - ApplicaitonTownofMontvillePlanning&ZoningCommissionSitePlanorSpecialPermitApplicationSitePlanNumberPlanDateRevisionSpecialPermitFeepaid_____________Revision-AssessorsMap____________LotProjectAddressNa me o f App l i c a n t _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _____ _ _ _ _ _ _ _AddressofApplicant_ _ __ _ _ _ __ _ _ _ __ _ _ _ __ _ _ _ __ _ _ _ _ProjectNameTel#Cell#Fax#Email____________Na me o f P ro pe r t y Ow n er __ _ _ _ _ _ _ _ _ _ __ _ __ _ __ _ __ _ _ _NameofAttorney__ _ _ _ __ _ _ _ __ _ _ _ __ _ _ _ __ _ _ _ __ _ _Tel#Cell#Fax# _________ _ _ _ _ _ _ _ _ _ _Email_____________Na me o f E n g i n e e r __ _ _ __ _ _ _ __ _ _ _ __ _ _ _ __ _ _ _ __ _ _Tel#Cell#Fax#EmailZoningDistrictLotSizeTotalAcres____________11Yes11NoRegulatedWetlandsAcreagePermitDate______________EIYesJNoFloodPlainFloodHazardAreaJYesJNoA-2SurveyNameofSurveyorBuildingsizeBuildingheightNumberofacrestobedisturbedApplicableZoningRegulation(s)__________________________________________________ProjectdescriptionThisprojectwilluse:JSepticsystemIEJMunicipalsewerDIndividualwelltElPublicwatersupplywellfEJSCWAwellfiMunicipalwater11YesIEINoThisprojectislocatedinaPublicWaterSupplyWatershed11YesINoThisprojecthasreceivedapprovalfromtheUncasHealthDistrictJYesJNoThisprojecthasreceivedapprovalfromtheappropriateWaterAuthority**AttachCopyofAllApprovalsPage1of2SitePlan/SpecialPermitApplicationH:\APP[_ICj\T1()NF()RN4\A.PPs&Guide1ine(Each)rc\•I—I6—201)(‘Stc—SPAPI’ revI—i5—201hdoc\X095001MTIC Acquisitions, LLCMohegan tribe language department860-862-6341lacampora@moheganmail.comMTIC Acquisitions, LLCLinda Acamporan/aR-20 and OZXXXSteven R. Marien, LS347945' (existing)n/aSec. 14a, Sec 17, Sec. 9, Sec. 4.11.4, Sec 18.3.3change of use from residential to business/professional office space inRoute 32 overlay zone.XXXXX13 Crow Hill Rd, Uncasville, CT 06382860-862-6122860-862-6341860-862-6122lacampora@moheganmail.com25 Church Lane, Uncasville, CT 06382 JYesIJNofElYesJNofiYesCE]NoIEJYesfiNotElYesCE]NofiYestElNoThisprojectrequiresaStateGeneralStormwater QualityPermit.Registration#________________ThisprojectrequiresapermitfromtheArmyCorpsofEngineers.ThisprojectrequiresaWaterDiversionPermit.ThisprojectrequiresaDamPermit.ThispropertyissubjecttoaConservationRestrictionand/oraPreservationRestriction.Ifyes,attachacopyofcertified notice.Drainagecalculationssubmitted:DateRev,dateRev, datetElYesCE]NoThisprojectrequiresaOSTA(OfficeofStateTrafficCommission)Permit.tElYestElNoThisprojectrequiresaDOTEncroachmentPermit.CEEIYesCEJNoTheplanhasbeensubmittedtothe DOTDistrict2Office.Numberofparkingspacesprovided_______________Numberofvehicletripsperdaygeneratedbythisproject______________EElYesCE]NoAdeterminationofapplicabilityofofthefollowingZoningRegulationsSectionsSignatureofApplicantDateSignatureofOwnerDateOFFICEUSEONLYReviewDate SentDateReceivedTownEngineerUncasHealthDistrictFireMarshalBuildingOfficialMayorWPCADOTDistrict2N.L.WaterOtherDateofReceipt___ __ _DateofExtension#1__ _ _ _ _DateofPublicHearing_ _ _ _ _ _DateofExtension#2_ _ __ __DateHearingClosedTerminalDateSitePlan/SpecialPermitApplicationPage2of211:\A.PPL[CAT[ONFORN4S\APPs&(iuidelines(EachrevII—i62OI“Site—SPAPPrevI52OdocxXXXXXXXXX1614A Route 32 overlay zone (OZ)