Conservation Commission - 1071 (05/08/2025)

TOWN OF WATERFORD
Application for Inland Wetland / Watercourse Permit
Type of Application: 
Agency Use:
Permitted Use, Section 4.1 
Date Received:
Unregulated Activities, Section 4.2 
0 
Received By:
Regulated Activities, Section 6 x 
Fee: 
re / 0 
Application Number: 
C- a c- Qo Ss”
1. Applicant: Heather Randazzo 
Phone:
Address; 
185 Route 163 Apt A Uncasville 
State: 
CT 
Zip: 06382
Fax: 
E-Mail; )andazz097@gmail.com
2. Owner: _ Same as applicant 
Phone:
Address: 
State: 
Zip:
Fax: 
E-Mail:
3._ Agent: 
CLA Engineers. Inc 
Phone; 860-886-1966
Address: 
317 Main Street 
Norwich 
State: 
CT 
Zip:06360
Fax: 
E-Mail; brusso@claengineers com
4. Property Address: 
_/ g 
CINITALLLA 
LANE
5. Abutting Property Owners — Complete Attached Form See attached
6. Activity to be Reviewed and / or Licensed (attach sheet if necessary):
Construction of a septic system, lawn and corner of a house within the 100 foot upland review zone
Dial) to alached
7. Description of Proposed Activity (attach sheet if necessary):
Construction of a house. garage. breezeway septic system and driveway. A site plan is attached
8. Purpose of Activity (attach sheet if necessary): To construct a residential dwelling
9a. Acreage of Property: 
2.91 ac 
9b. Acreage of Wetlands: 
0.21
10. Acreage of Wetlands Altered: 0.0
11, Wetland Mitigation Proposed: 0 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 in all supporting documents according to the best of
his / her knowledge, information and belief.
Applicant: Yea” Vag 
Date: 4/\7/95
Owner: 
Yea bo 
Date: 4/7 [8
Agent: 
Date:
MAY 0 1 2025
Planning & Development
Town of Waterford, CT

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Connecticut Department of
GISCODE#;
ENERGY & 
For DEEP 
Use Only
=
PROTECTION
79 Elm Street ¢ Hartford, CT 06106-5127 
www.ct.gov/deep 
Affirmative Action/Equal Opportunity Employer
Statewide Inland Wetlands & Watercourses Activity Reporting Form
Please complete this form in accordance with the instructions on pages 2 and 3 and mail to:
DEEP Land & Water Resources Division, Inland Wetlands Management Program, 79 Elm Street, 3" ¢ Floor, Hartford, CT 06106
Incomplete or incomprehensible forms will be mailed back to the inland wetlands agency.
PARTI: Must Be Completed By The Inland Wetlands Agency
1. 
DATE ACTION WAS TAKEN: 
year: 
month:
2. 
ACTION TAKEN (see Instructions - one code only):
3. 
WAS A PUBLIC HEARING HELD (check one)? 
yes [] 
no
4. 
NAME OF AGENCY OFFICIAL VERIFYING AND COMPLETING THIS FORM:
(print name) 
(signature)
PART Il: To Be Completed By The Inland Wetlands Agency Or The Applicant
6, TOWNIN WHICH THE ACTIVITY IS OCCURRING (printnamey; _ Waterford
does this project cross munlclpal boundaries (check one)? 
—-yes (-] 
no {2
if yes, list the other town(s) In which the activity Is occurring (print name(s)): 
i
6, 
LOCATION (see Instructions 
for information); USGS quad name; Montville 
or number; 86
subregional drainage basin number: 3006
7. 
NAME OF APPLICANT, VIOLATOR OR PETITIONER (print name); eather Randazzo
8, 
NAME & ADDRESS OF ACTIVITY / PROJECT SITE (print Information); 18 Cinderella Lane
briefly describe the action/project/activity (check and print Information): temporary [7] 
permanent [7] 
description:
Construct house and garage
9, 
ACTIVITY PURPOSE CODE (see Instructions - one code only): 
B
10. ACTIVITY TYPE CODE(S) (see Instructions for codes): 
12 
4
11. WETLAND / WATERCOURSE AREA ALTERED (see instructions for explanation, must provide acres or linear feel):
9 
acres 
stream: 
© 
linear feet
wetlands: 
0 
acres 
open water body:
12, UPLAND AREA ALTERED (must provide acres); 2-5 
acres
13. AREA OF WETLANDS / WATERCOURSES RESTORED, ENHANCED OR CREATED (must provide acres): 
0 
acres
DATE RECEIVED: 
PART Ill: To Be Completed By The DEEP 
DATE RETURNED TO DEEP:
FORM COMPLETED: YES 
NO 
FORM CORRECTED 
/ COMPLETED: YES NO
rev. 1/2024 pdt