Zoning Board of Appeals Application (PDF)

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Variance Application to the 
Zoning Board of Appeals 
   Property Address: ____________________________________________________________ 
Name: ___________________________________________________ Telephone#:_____________________________ 
Address:  ________________________________________________ Cell Phone#: ____________________________ 
City/State: _______________________________________________ Email: _________________________________ 
Name: ___________________________________________________ Telephone#:_____________________________ 
Address:  ________________________________________________ Cell Phone#: ____________________________ 
City/State: _______________________________________________ Email: _________________________________ 
Name: ___________________________________________________ Telephone#:_____________________________ 
Address:  ________________________________________________ Cell Phone#: ____________________________ 
City/State: _______________________________________________ Email: _________________________________ 
I/We hereby apply for: 
Variance from the Zoning Regulations 
Repairer’s/Dealer’s License 
Residential 
CAM Residential 
Location of Approval DMV 
Other Residential 
CAM Non-Residential 
Other:   
Non-Residential 
1.
Type of Variance Application(s) (Check all that apply)
2.
Owner(s) of Record (As listed on deed)
3.
Applicant Information
4.
Agent Information
5.
Application Request Type
Town of Waterford 
Department of Planning and Development 
www.waterfordct.org 
Office Use Only 
Date Submitted: 
Processed By: 
App. No.: 
Total Fee: $  

  
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Map/Block/Lot: 
/ 
/  
   
/ 
/ 
     Street No. & Name: __________________________________ 
Approximate Size SF/AC: 
/ 
 
  Date acquired: _________________ Zone(s): ___________________ 
Deed recorded in Waterford Land Records Volume Number: ____________________ Page(s): ___________________ 
Located on the side _____________  of __________________________________________  ,  _____________ feet 
 
 _____________________________ from the intersection of  ____________________  and ____________________ 
 
The variance relates to (please check one): 
  Use: 
Area:  
Frontage: 
 
Yards/Setbacks: 
Signs:  
Dealer/Repairer: 
 
 
 
REQUIRED 
EXISTING 
PROPOSED 
MINIMUM LOT SIZE 
 
 
 
MINIMUM FRONTAGE 
 
 
 
MINIMUM FRONT YARD 
 
 
 
MINIMUM SIDE 
 
 
 
MINIMUM REAR YARD 
 
 
 
MAXIMUM BUILDING COVERAGE 
 
 
 
MAXIMUM BUILDING HEIGHT 
 
 
 
MINIMUM PARKING SPACES 
 
 
 
 
 
    Attach additional sheet if necessary 
 
 
 
 
 
 
 
     Attach additional sheet if necessary  
 
 
 
 
 
 
 
      
 
 
6. 
Parcel Information  
7. 
Zone District 
8. 
Under what section(s) of the Zoning Regulations is the appeal based? 
9. 
Specifically state amount of variance or action Board is requested to take: 
10. 
What is the hardship claimed? See Sections 27.4 and 27.5 of the Zoning Regulations 
(N, S, E, W) 
(N, S, E, W) 
(STREET) 
(STREET) 
(STREET) 

  
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Yes   
  
 
No 
 
If yes,  ______________________________________________ and  _________________________________________ 
 
 
Is the property within the Coastal Area Management Boundary? 
 
 
Yes 
 
No 
Is a CAM report required? 
 
 Yes  
 
No 
If yes, is the report attached?  
 Yes  
 
No 
 
If No, note the exempt section(s) of Zoning Regulations ____________________________________________________ 
 
 
 
By signing below, the Owner and Applicant hereby grant the Waterford Zoning Board of Appeals and its authorized agents, 
including the Zoning Enforcement Officer, and Town Public Works Staff, the right to enter the premises, subject of the 
application, to inspect and verify the information contained in the variance application. 
 
I/We hereby depose and say that all the above statements and the statements contained in any papers submitted herewith are 
true to the best of my knowledge and belief. 
 
 
 
 
 
 
 
 
 
 
 ___________________________________________________    ____________________________________________ 
 
 ___________________________________________________    ____________________________________________ 
 
 
11. Has/Have any previous appeal(s) been filed in connection with these premises during the past         
ten calendar years? 
Date(s) 
Appeal Number(s) 
12. 
Coastal Area Management Boundary 
13. 
Owner, Applicant and/or Agent Acknowledgement 
Signature of Owner 
Date 
Signature of Applicant/Agent 
Date 

ZONING BOARD OF APPEALS  
APPLICATION CHECKLIST 
Applications for the Zoning Board of Appeals must include the following: 
Fees
Please note: Fees are determined by a standard process fee in addition per variances.
Cash or check is the accepted form of payment.
Submission of two sets of the following:
Application
Plot plans
Legal description (deed)
List of all property owns within 150 feet
Town of Waterford Assessor’s map of property owners within 150 feet
Town of Waterford Assessor’s street card
The Zoning Board of Appeals will require at least 10 additional copies after review of the 
application, depending on what variances are requested. The applicant will be notified by the 
Zoning Board of Appeals office on how many and when the additional copies are required. 

REV 1- F:\PUBLIC\WS\ZBA\FORMS\wip\ZBA App List of Owners REV 1.docx 
W A T E R F O R D  Z O N I N G  B O A R D  O F  A P P E A L S  
LIST OF PROPERTIES WITHIN 150’ 
  SUBMIT THIS FORM WITH APPLICATION 
OF PROPERTY LOCATED AT:    
OWNER 
UNIQUE ID 
PROPERTY ADDRESS 
MAILING ADDRESS 
Last Name 
First Name 
T O W N  O F

REV 1- F:\PUBLIC\WS\ZBA\FORMS\wip\ZBA App List of Owners REV 1.docx 
W A T E R F O R D  Z O N I N G  B O A R D  O F  A P P E A L S  
LIST OF PROPERTIES WITHIN 150’ 
  SUBMIT THIS FORM WITH APPLICATION 
OF PROPERTY LOCATED AT:    
OWNER 
UNIQUE ID 
PROPERTY ADDRESS 
MAILING ADDRESS 
Last Name 
First Name 
T O W N  O F