Conservation Commission Agenda (linked)

Application for Inland Wetland / Watercourse Permi
Type of Application:
Permitted Use, Section 4.1
Unregulated Activities, Section 4.2
Regulated Activities, Section 6 x
TOWN OF WATERFORD
Agency Use:
Date Received:
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OCT 2 2 2024
Planning & Development
Town of Waterford, CT
Received By:
Fee: 116 od
Application Number: —_ C - AL4H-10
1. Applicant: Uzair Shagufta Phone: 860.514.5207
Address: State: Zip:
Fax: E-Mail; UZairmanzor@gmail.com
2. Owner: Uzair Shagufta Phone: 860.514.5207
Address: State: Zip:
Fax: E-Mail: UZairmanzor@gmail.com
3. Agent; Brian D. Florek, LS CFS Phone: 060.271.6006
Address: 239 Shore Road, Waterford State. CT Zip, 06385
Fax: E-Mail: Dflorek@floreksurveyingllc.com
4. Property Address: 81 Miner Lane
5. Abutting Property Owners — Complete Attached Form
6. Activity to be Reviewed and / or Licensed (attach sheet if necessary):
Proposed house, pool, shed, and lot clearing within the 100' upland review area.
7. Description of Proposed Activity (attach sheet if necessary):
Construct a home, pool and shed.
8. Purpose of Activity (attach sheet if necessary): Construct a home
9a. Acreage of Property: 2.96 acres 9b. Acreage of Wetlands: 1.40
10. Acreage of Wetlands Altered: 0
11. Wetland Mitigation Proposed: 0
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 property under consideration. The undersigned warrants the truth of all statements contained
herein and inyall supporting documents according to the best of his / her knowledge, information and belief.
Applicant: Ce— Zz Date: /¢ /7 /i4
Owner: bias Yo Date: _/0 | 74,
Agent: We IZ V7 tE CHS Date: 2] f 74
IWW Permit Application form
Updated 3 2011

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