HomeMy WebLinkAbout22-28W Russel Minimal ImpactTOWN OF SOUTH WINDSOR Fee $110.00
Mir^HMAL JJkrpACT INLAND wETLANDs, wATERcOuRSEs AND CONSERVATION
APPLICATION
Application #Date Received Action and Date
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: ELOA^J RuSS4J`
;;dress.. ife____P14QLsa~+ troll.i ELd.
8. Legal owner's name:
Address
Phone (home)
(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 part of the application.
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 #Parcel #Zone
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:
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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.)
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.
Signature of Applicant
Date
2