Planning & Zoning Commission (linked)

Office Use Onl
Town of Waterford jee Use Only
Department of Planning and Development Date Submitted:
Processed By:
www.waterfordct.org
App. No.:
Total Fee: $
PZC Form 1 Electronic Submission
Waived: Yes No
Planning and Zoning Application
1. Type of Application(s), Use and Property Information (check all that apply)
| | Informal Staff Review [Ml] Site Plan/Design Review [__] Municipal Project (CGS§8-24)
LJ Special Permit/Design Review! [| Subdivision /Resubdivision [| Lot line Adjustment
[| Zoning Map Change [| Regulation Amendment(s) [| New District
[| Multifamily Development [| Coastal Area Management ” [| Earth Excavation
[| Flood Hazard Area [| Other: [| Other:
Specify all uses and corresponding section for which this application applies’:
_ Retail Stores and Service Establisments _ 9.1.2
Use: Section:
Use: Section:
Use: Section:
Wal-Mart (expansion of existing use)
Name of proposed development/subdivision: If subdivision how many lots?:
If applicable, are roadways proposed to be private, public or both: Not Applicable
[| Private [| Public [| Both*
Parcel 1 Parcel 2
Map/Block/Lot: 98 / / B70 / / Map/Block/Lot: / / / /
155 Waterford Parkway North
Street No. & Name: Street No. & Name:
2532142.8 58.1 3
Size SF/AC: Size SF/AC: /
. oo Regional Commercial (C-R) . ae
Zoning District(s): Zoning District(s):
‘Include a completed list of property owners with Parcel ID, name, address and mailing address. It is the applicant’s responsibility to distribute all
notices certified return receipt. Evidence of mailing shall be submitted prior to the start of the hearing. Failure to do so will delay the opening of the
hearing.
* Coastal Site Plan reviews under Coastal Area Management §25.4 must submit a completed PZC Form 2 in addition to this PZC Form 1.
3 The use listed must correspond to the exact use term noted within the zoning district as a permitted use allowed through site plan or special permit.
“A plan must accompany the application clearly delineating the limits of public and private roads.







14. Supporting Documentation
Itemize, including additional attachments, all information provided in support of the application. Titles, dates and
sheet/map numbers shall correspond exactly with the corresponding information provided.
Additional pages attached, if necessary: LI Yes [ No
Please refer to attached project narrative
15. For Informal Staff Review Use Only
Sec. 7-159b — Pre-application review of use of property. Notwithstanding any other provision of the general statutes,
prior to the submission of an application for use of property under chapters 124, 126, 440 and 541 or any other provision
of the general statutes authorizing an authority, commission, department or agency of a municipality to issue a permit or
approval for use of such property, such authority, commission, department or agency or authorized agent thereof may
separately, jointly, or in any combination, conduct a pre-application review of a proposed project with the applicant at
the applicant's request. Such pre-application review and any results or information obtained from it may not be appealed
under any provision of the general statutes, and shall not be binding on the applicant or any authority, commission,
department, agency or other official having jurisdiction to review the proposed project.
I have read and understand the above provision of the Connecticut General Statutes and understand and agree that
whatever discussion, comments and/or recommendations are made through this review are non-binding upon the parties.
Further, I acknowledge and agree that this pre-application review meeting is being conducted prior to and in anticipation
of a formal application to the Waterford Planning and Zoning Commission or Conservation Commission to obtain
feedback and response to the proposal or design, as it exists on this date, in the interest of preparing an application
consistent with the Subdivision, Zoning or Wetlands regulations of the Town of Waterford as the case may be.
Signature Printed Name Date
Mike Rutherford Mike Rutherford 9/16/24
Applicant
He Ay ber Greg DiBona 9/16/2024
Agent
same as applicant
Land Owner
Land Owner

16. Technical Assistance Review Fee
In accordance with the Waterford Code of Ordinance Chapter 16.08, the Commission may require third party technical
assistance review for the evaluation of applications associated with but not limited to site plans, special permits, zone
change and regulation amendments and may collect payment for costs associated with the review. This includes but is not
limited to civil engineering, architecture, legal assistance, traffic engineering and environmental protection.
17. Acknowledgements; All applications
Application Content
The undersigned herby acknowledges that this application and statements submitted herewith are true to the best of my
knowledge and approval of the application is contingent upon compliance with all requirements of said regulations.
Right of Entry and Inspection
The undersigned hereby authorizes the Waterford Planning and Zoning Commission or its agents, to enter the subject
property for the purposes of inspection and enforcement for the said Zoning Regulations until receipt of final Certificate
of Occupancy and Certificate of Zoning Compliance.
Electronic Data Accuracy and Transmission
If applicable, the undersigned hereby acknowledges that all electronic data submitted as part of this application is an
accurate and true representation of all paper transmissions provided as part of this application and may be transmitted
publically when requested and all applicable fees are paid in full by the requesting party.
Signature Printed Name Date
Maite Rullurford. Mike Rutherford 10/17/24
Applicant
A he Greg DiBona 10/17/2024
Agent
same as applicant
Land Owner
Land Owner