General Building and Zoning Compliance Permit (PDF)

TOWN OF WATERFORD, CT – PLANNING AND DEVELOPMENT 
APPLICATION FOR ZONING COMPLIANCE AND BUILDING PERMIT 
                                                                                                                    
LOCATION INFORMATION: 
 
Property Address ________________________________________Unit #_________Waterford _____Quaker Hill___________ 
 
 
 
 
 
 
 
 
 
          Cell # (        )_________________________ 
Owner_______________________________Leasee__________________________Telephone # (         )____________________ 
 
Address__________________________________________________________________________________________________ 
 
 
            Street 
 
 
                                              City/Town                  State              Zip Code 
 
CONTRACTOR/AGENT INFORMATION: 
 
 
 
 
 
 
 
 
                Cell # (      ) _________________________________________ 
Contractor/Agent________________________________________________Telephone # (        )__________________________ 
 
Address__________________________________________________________________________________________________ 
 
 
 
Street                                                                          City/Town                  State      Zip Code 
 
Contractors License #__________________________________________  Expiration Date______________________________ 
 
Workers Compensation insurance submitted?  YES____________________Affidavit  YES_____________________________ 
 
PERMIT REQUEST: 
 
Purpose of Permit__________________________________________________________________________________________ 
 
_________________________________________________________________________________________ 
 
_________________________________________________________________________________________ 
 
_________________________________________________________________________________________ 
The owner of the above property guarantees that all the applicable requirements of the Town of Waterford, Zoning 
Regulations, CT Basic Building Code and the CT Public Health Code in so far as they apply to the design, erection and location 
of the building described in this application will be strictly complied with.  And also authorizes the Planning & Zoning 
Commission, Building and Health Department and its staff to enter upon the property in question for the purpose of inspection 
and enforcement with regard to all of the above requirements. 
 
Property Owner Signature__________________________________________________  Date______________________________ 
Printed Owner’s Name____________________________________ Email Address _______________________________________ 
 
Contractor/Agent_________________________________________________________   Date______________________________ 
Printed Contractor/Agent Name____________________________  Email Address _______________________________________ 
 
I hereby certify that the proposed work is authorized by the owner in fee and I have been authorized by the owner to make this 
application as his authorized agent. 
************************************************************************************************* 
OFFICE USE ONLY 
 
 
Building Permit                            T/C  [   ]                  U/C   [   ] 
Estimated Cost $  
#B - 1     -     
P/S   [   ]                  S/S    [   ] 
 
 
City Water [   ]       Well [   ] 
Fee $ 
Zoning Compliance 
Excavation Permit  Yes  [   ] No [  ] 
 
Permit #Z-1 
Ledge Light Health Yes  [  ] No [  ] 
State Fee $ 
 
Fire Marshall             
 
Site Work  
Police Department             
C of O Fee  $50.00            $100.00       
Estimate $ 
Other 
 
 
 
Total $ 
Fee $  
Applicant Notified: