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HomeMy WebLinkAboutApplicationTown of Montville – Bridge Street Bridge Deck Replacement Abutting Property Owners Ragozzine, Michael & Julie 30 Bridge Street Uncasville, CT 06382 082-082-000 Elkins, Adam D 31 Bridge Street PO Box 5 Uncasville, CT 06382 082-054-000 No # Bridge Street Tom McNally DBA T&S Lawn Care LLC 1017 East Lake Rd Oakdale, CT 06370-1818 082-053-000 257 Maple Avenue Samolis, Sandra S 1851 Route 32 Uncasville, CT 06382 082-083-000 rev. 1/2024e 79 Elm Street • Hartford, CT 06106-5127 www.ct.gov/deep Affirmative Action/Equal Opportunity Employer Statewide Inland Wetlands & Watercourses Activity Reporting Form Please complete and mail this form in accordance with the instructions. If completing by hand - please print and use the pdf version. Incomplete or incomprehensible forms will be mailed back to the municipal inland wetlands agency. PART I: Must Be Completed By The Inland Wetlands Agency 1. DATE ACTION WAS TAKEN: year: Click Here for Year month: Click Here for Month 2. CHOOSE ACTION TAKEN (see instructions for code): Click Here to Choose a Code 3. WAS A PUBLIC HEARING HELD (check one)? yes no 4. NAME OF AGENCY OFFICIAL VERIFYING AND COMPLETING THIS FORM: (type name) (signature) ______________________________________ PART II: To Be Completed By The Inland Wetlands Agency Or The Applicant 5. TOWN IN WHICH THE ACTIVITY IS OCCURRING (type name): MONTVILLE does this project cross municipal boundaries (check one)? yes no if yes, list the other town(s) in which the activity is occurring (type name(s)): , 6. LOCATION (click on hyperlinks for information): USGS quad map name: MONTVILLE or quad number: 86 subregional drainage basin number: 3004 7. NAME OF APPLICANT, VIOLATOR OR PETITIONER (type name): TOWN OF MONTVILLE 8. NAME & ADDRESS OF ACTIVITY / PROJECT SITE (type information): BRIDGE STREET (NEAR #30) briefly describe the action/project/activity (check and type information): temporary permanent description: TEMP. DISTURBACEN FOR SCAFOLDING AND PERSONELL FOR A BRIDGE DECK REPLACEMENT 9. ACTIVITY PURPOSE CODE (see instructions for code): E 10. ACTIVITY TYPE CODE(S) (see instructions for codes): 9, 12, Click for Code, Click for Code 11. WETLAND / WATERCOURSE AREA ALTERED (see instructions for explanation, type acres or linear feet as indicated): wetlands: acres open water body: acres stream: linear feet 12. UPLAND AREA ALTERED (type acres as indicated): 0.04 acres 13. AREA OF WETLANDS / WATERCOURSES RESTORED, ENHANCED OR CREATED (type acres as indicated): 0.00 acres DATE RECEIVED: PART III: To Be Completed By The DEEP DATE RETURNED TO DEEP: FORM COMPLETED: YES NO FORM CORRECTED / COMPLETED: YES NO GIS CODE #: ____ ____ ____ ____ ____ ____ ____ ____ ____ For DEEP Use Only Copyright:© 2013 National Geographic Society, i-cubed LOCATION MAP ± DATE: 4/7/2025SCALE:SOURCE: USGS Quad 1 FIGURE1 in = 2,000 ftBridge Street Bridge Deck Replacement Montville Quad (#86) Project Location