HomeMy WebLinkAboutMinimal Impact (11) RECEIVED
TOWN OF SOUTH WINDSOR -11JL 2 3 2004 Fee $70.00
MINIMAL IMPACT INLAND WE1%AND9pVATJWCOURSES AND CONSERVATION
APPLICATION
Application # 4 4_'IYL3 Date Received 7 A3 -6-L1 Action and Date 8-U 04
INSTRUCTIONS
1. One application (1) with map and plans (1 copy) shall be submitted together with
the fee set forth in the Inland Wetlands, Watercourses and Conservation
Regulations, Town of South Windsor. (See Regulations, Section VII -X)
2. The South Windsor Inland Wetlands, Watercourses and Conservation Regulations
should be reviewed with respect to the standards and criteria for application
Evaluation. (See Regulations, Sections VII -X)
3. The applicant understands that this application is to be considered complete only
when all information and documents required by the Agency have been submitted.
The applicant shall also complete the state filing form.
A. Applicant's Name: C.(4U rf Yam. T)U S
Address: 1 (3-1 N C,*5-)5 JM Y cvr rY-\
Phone: (home)�30- I' -I(work) R101 (fax)
B. Legal owner's name: 5r-��
Address
Phone (home) S (work) (fax)
(List additional owners, addresses, and phone numbers on back of application)
C. If the applicant is not the owner of the subject property; a letter by the owner(s)
authorizing the proposed regulated activity set forth in the application must
accompany-this form and-will be--par-t of the �pplic-ation. -
D. The geographical location of the property which is to be affected by the proposed
regulated activities including a description of the land in sufficient detail to allow
identification of the property on the Inland Wetland and Watercourse Map.
Street Address #
Assessor's Map # J6?- Parcel # 36 Zone J4 3
E. Purpose and description of all proposed regulated activity(s) including amount of
disturbance in square feet and types of fill and the time element involved:
F. Identify all other permits or approvals that have been issued, applied for, or
required with respect to the proposed activity set forth in this application. (These
may include but not be limited to, local Planning & Zoning, Zoning Board of
Appeals, D.E.P., F.E.M.A., D.O.T., The Army Corps of Engineers, and any other
State, Local or Federal Permits.) Pt.t (� ;
The undersigned hereby applies for the regulated activities listed in paragraph F
above, for a Minor Impact Inland Wetlands, Watercourses and Conservation permit for
the property described herein and confirms that:
1. She/he is familiar with the currently effective Inland Wetlands, Watercourses and
Conservation Regulations of the Town of South Windsor.
2. She/he understands that at any time during the review period, the Agency may
require the applicant to provide more information about the wetlands and/or
watercourses in question and/or any proposed activity.
3. All information submitted in the application for review shall be considered factual,
or in the case of anticipated activity, binding. A knowing failure of the applicant or
any of her/his agents to provide correct information, or performance exceeding the
levels of activity anticipated, shall be sufficient grounds for revocation of any permit
under these regulations.
4. By making this application, the applicant gives permission to the Inland Wetlands,
Watercourses and Conservation Commission members and/or its representative to
enter the portions of the premises which are subject of the application for the
purpose of inspection and investigation and otherwise evaluating the merits of the
application both before and after a final decision has been issued.
5. Upon approval by the authorized Agent the applicant shall cause notice of the
decision to be published in a daily newspaper having a general circulation in the
Town where the activity occurs. The notice must be published within ten (10) days
of the decision.
6. Appeals of this decision may be brought to the Agency within fifteen (15) days after
the publication date of the notice.
1C
Signature of Owner of Property �) c�3
Date
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Signature of Applicant
Date ^v
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x Town 0_.PS-0ut4 ?dt
s 1540 SULLIVAN AVENUE • SOUTH WINDSOR, CONN. 06074
�SOR•CO AREA CODE 860/644-2511
CERTIFIED MAIL July 23, 2004
Claire Dusik
107 Natsisky Farm Road
South Windsor, CT 06074
RE: Appl. #04-48W,Dusik Minimal Impact Application, 107 Natsisky Farm Road, A-30 Residential
Zone
Dear Mrs. Dusic:
The Inland Wetlands Agency/Conservation Commission, through staff has approved minimum impact
application#04-48W—Dusic, 107 Natsisky Farm Road. Inland Wetland/Conservation Commission
minimal impact application for the placement of a shed within the upland review area(Assessor's Map
#129, parcel#30. This approval is subject to the following conditions:
1. The application shall indemnify and hold harmless the Town of South Windsor against any liability,
which might result from the proposed operation or use.
2. The permit is valid for five years and shall expire on July 23 2009. It is the
landowners)/applicant(s)responsibility to track expiration dates and notify the Commission of a
renewal request at least 65 days prior to expiration.
3. All additional approvals required must be obtained and submitted prior to any activity on the site.
4. The applicant shall cause notice of the decision to be published in a daily newspaper having a
general circulation in the Town. The notice must be published within ten(10) days of the receipt
of the decision. The applicant must notify the Planning office of the date of publication and
fax-or mail a copy of the published legal notice. Appeal of this decision may be brought to the
Agency within fifteen(15) days after the publication date of the notice.
Very truly you`r's,
C V
Jeffrey H. Folger, Environmental Planner
INLAND WETLANDS AGENCY/
CONSERVATION COMMISSION
cc: Inland Wetland/Conservation Commission
Director of Planning
Chief Building Official