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TOWN OF SOUTH WINDSOR Application # �-q-0,9,
APPLICATION FOR Date /f--I q-o,;,-
ZONING BOARD OF APPEALS Receipt# ICJ
IMPORTANT.- This application must be submitted to the Planning Department by the second Thursday of the
preceding month to insure being heard at the next meeting.
ALL.ITEMS MUST BE ANSWERED AND ALL SUPPLEMENTS MUST BE SUBMITTED.
1. The application and supplements must be filed in duplicdte, typed or printed in ink.
2. A Class D or better survey of the property in question must be submitted with the application showing
streets, lot lines, building lines, zone boundary lines, dimensions, and buildings present or proposed and
buildings on adjacent properties and distance from subject property.
3. If a variance is being requested, a legal description and deed of the property must be submitted with the
application. This description can be obtained from the land records.
4. The sign from the Planning Department must be displayed on the property at least 10 days prior to the public
hearing in a location visible from all abutting streets.
• The applicant, or a representative must be present for the public hearing. The time, date and place of the
hearing will be advised by mail.
• Inquiries on this application may be directed to the Planning Department at the South Windsor Town Hall.
5. No application shall be a complete application unless it shall beiin such form and contain such
information as necessary for a fair determination of the issues. Incomplete applications may be
denied.
2. Mailing Address: i Yv Ro^-
so,1 Sc/n- CT 0 6 C 7 ''
3. Telephone#:
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4. Owner of record of property in question: CA 0 0 �j�}Ce►.i i 141 Nw �i Ace
5. Location of property in question: 661 R&,f 4
Assessor's Map # Parcel # 1 Lf Zone ,--„110
6. Is applicant a corporation or co-partnership? (If corporation, submit a list of officers. If co-partnership,
submit a list of owners).
SECTIONII-REQUIRED.INFORMAT'ION continued
7. Please indicate if the applicant is owner, lessee, or prospective tenant: (OCJL) rv\e�
8. Check one of the following:
( Request Variance to Section of the Zoning Regulations to allow CO A/STa v e T 14A./
1 �v e �y�t0 v,v iJ IDd4 / C lose n AAAt v
( ) State hearing under Section of the General Statutes for .
( ) An appeal from the Zoning Officer's decision involving
9: is this a request for a sign variance? If yes, complete and submit the sign checklist information. 14
10. If application is for a variance to Section 3.12, are there any liquor outlets within the restricted area,
(500 feet)? YES or NO If yes, submit a list of liquor outlets, their locations and distances from the
property in question. 1✓/O
11. Is this property within 500 feet of another town line? d P/14
12. Is this property within the Connecticut Water Aquifer area? Yes o If yes, application must be filed
with the.Connecticut Water Company by the applicant. x//* .
13. If requesting a variance state clearly the unusual hardship or exceptional difficulty on the property that
prompts this application and indicate why other options are unacceptable. Use a separate sheet of paper if
necessary.
I hereby declare that the data& information contained herein is accurate to the best of my knowledge.
Dated this y of OCT-0,t3E/2 Year
Applicant:
(Signature)
OWNER: �it91
(Signature)
SECTION ZT%=-ACTION0 TI,E BOARD =k � vY b
Approved: Denied:
Revised 12/04/98
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