Conservation Commission Agenda (linked)

TOWN OF WATERFORD
Application for Inland Wetland / Watercourse Permit
Type of Application: Agency Use:
Permitted Use, Section 4.1 Date Received:
Received By:
Unregulated Activities, Section 4.2
Regulated Activities, Section 6 v Fee: AL, /o Application Number:
{. Applient: 5 oo” niger LAL. Lyle ZLC Phone: to ltd OFFS
Address: AES AL LMDLEE ke Lipase lle : State: Vie Zip: OGBE EZ
Fax: V4 EMail: S/YWae. Sip Lie! Quntt Lr
2. Owner: Suro ; Phone:
Address:
State: Zip:
Fax: E-Mail:
3. Agent: XM, ty 04 Phone:
Address:
State: : _ Zip:
Fax: E-Mail:
4. Property Address: a Loom (16 allt. hie
5, Abutting Property Owners — Complete Attachéd Form
6. Activity to be Reviewed and / or Licensed (attach sheet if necessary):
KE (Sslile SUbUUl Sts) ppg | ah. ED AE! = M SUE,
7. Description of Proposed Activity (attach sheet if necessary): ; OCT 2 0 2025
Ni _htne. Lyall 2 Stil er omnes
/ 7 . Pranic DEVE pierre
‘Town of Waterford, CT
8. Purpose of Activity (attach sheet if necessary):
9a. Acreage of Property: 3A 47) [EZ 9b. Acreage of Wetlands: DX. (2
10. Acreage of Wetlands Altered: D
11. Wetland Mitigation Proposed: OQ)
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: No:
The applicant / owner hereby gives the Commission, its agent and consultants the right of free access to any
part of the property under consideration. The undersigned warrants the truth of all statements contained
herein and in all supporting documents according to the best of his / her knowledge, information and belief.
Applicant: La. Z, J oe ae Date: 1
Owner: Y Tn fo ZL, Lok. Date: _, 4 / LC) 2)
Agent: : Date:
IWW Permit Application form
Updated 3 2011