HomeMy WebLinkAbout24SUB4 - Rev ApplicationH:\APPLICATION FORMS\APPs & Guidelines (Each) rev 11-16-2018\Subdivision Resubdivision APP rev 11-15-2018.doc
Permit # ____________ Fees $ ______________
Subdivision/Resubdivision Application
Assessors Map _______ Lot _______ Acres_________ Zoning District________ # Of lots________
Project address: ____________________________ Subdivision Name ____________________________
Resubdivision only:
Name of original Subdivision ________________________________________________________
Date of Commission Approval _______________________________________________________
Property owner name:
Property owner address: 888 Prospect Street, Suite 200, La Jolla, CA 92037
Applicant name: ________________________________________________________________________
Applicant address: _______________________________________________________________________
Tel # _____________________________________Cell # _______________________________________
Fax # ________________________Email ____________________________________________________
Engineer name: _________________________________________________________________________
Tel # _____________________________________Cell # _______________________________________
Fax # ________________________Email ____________________________________________________
Attorney name: __________________________________________________________________________
Tel # _____________________________________Cell # ________________________________________
Fax # _______________________Email_____________________________________________________
Regulated wetlands yes no
Public water supply watershed yes no
Community well system yes no
Flood Hazard Area yes no Flood zone _______________
Municipal water yes no
Individual well yes no
Subsurface sewage disposal yes no
Municipal sewer yes no
Coastal Management Area yes no
Ct General Stormwater
Quality Permit yes no
Army Corps of Engineers yes no
Water diversion permit yes no
Dam permit yes no
Subject to a conservation restriction and/or a preservation restriction
yes no
Office of State Traffic Commission (OSTA )Permit
yes no
DOT encroachment permit yes no
Waiver(s) requested yes no Regulation section(s) _____________
Erosion & sediment control bond $_________________
Performance/Road bond $_________________
Subdivision/Resubdivision Application Page 1 of 2
046 008 29.65 R120 2958 Route 163 Proposed 1-Lot Resubdivision of 958 Route 163
Proposed 1-Lot Subdivision of 958 Route 163
Submitted 7/19/23, never approved
TA CT Holdings LLC, a Delaware limited liability company
The Nevar Company / Dean Fiske677 S. Main Street, Cheshire, CT 06410(203) 410-7827
dbfiske.ravenswood@att.net
Kevin Solli, P.E.(203) 880-5455 (203) 848-5862(203) 880-9695 kevin@sollillc.com
James Miele(203) 272-0371 jmm@mielelaw.com
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N/A
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77,341.00
30.66
Mostowy One Lot Subdivision
November 5, 1986
10/25/24
10/25/24