Conservation Commission (linked)

TOWN OF WATERFORD
Application for Inland Wetland / Watercourse Permit
Type of Application: Agency Use:
Date Received:
Permitted Use, Section 4.1
Unregulated Activities, Section 4.2 Received By:
Application Number:
Regulated Activities, Section 6 X Fee: $110.00
1. Applicant: Congregation Beth-EL, Inc. Phone: 860-501-1350
Address: P.O. Box 1310 New London State: Connecticut Zip: 06320
Fax: office@bethel-nl.org E-Mail: office@bethel-nl.org
2. Owner: Congregation Beth-EL, Inc. Phone: 860-501-1350
Address: P.O, Box 1310 New London State: Connecticut Zip: 06320
Fax: - E-Mail: office@bethel-nl.org
3. Agent: Wayne S. Garrick, AIA Phone: 203-776-1874
Address: 291 Whitney Avenue New Haven State: Connecticut Zip: 06511
Fax: a E-Mail: wsga291@yahoo.com
4. Property Address: 33 Kenyon Road
5. Abutting Property Owners — Complete Attached Form See Attachment A
6. Activity to be Reviewed and / or Licensed (attach sheet if necessary):
Construction of buildings, parking area, sidewalk, waste and recyclables receptacle enclosure, utility services, stormwater infiltration area,
exterior lighting, and placement of fill and grading within the inland wetland 100-foot upland review area, and placement of fill in and
stormwater discharge to an inland wetland.
7. Description of Proposed Activity (attach sheet if necessary): See Attachment B
8. Purpose of Activity (attach sheet if necessary): Construction of a new synagogue and associated site improvements.
9a. Acreage of Property: 2.58 9b. Acreage of Wetlands: 0.21 +/-
10. Acreage of Wetlands Altered: 0.01 Ac.
11. Wetland Mitigation Proposed:
12. Section 7 and sections 8.1 & 8.2 of the Town of Waterford “Inland Wetlands and Watercourse Regulations”
have been complied with: (Review attached check list) Yes: X No:
The applicant / owner hereby gives the Commission, its agent and consultants the right of free access to any
part of the re y under consideration. The undersigned warrants the truth of all statements contained
I
herein and in al parting documents according to the best of his / her knowledge, information and belief.
MA. LekP Rice ARBOAT TEST Date: tnlw
Owner: - Foe OWER K Date:
a Rune VAL Losec Ap OARS ates A: 22-222
*REU CIOS ELIDA
[WW Permit Application form
Updated 3.2011