Online Link to List of Forms (ignore on printed copy)


BUILDING/ENGINEERING/ ZONING/WETLANDS

ROUTING SHEET

ADDRESS OF PROPERTY_____________________________________________________

TAX MAP_____ BLOCK _____ LOT _____ SIZE OF LOT_________________in sq. ft.

PROPOSED WORK____________________________________________________________

CURRENT USE: (Circle all that apply.) Single family, 2-family, Multi-family (# of units)___, Commercial, Industrial

Will the property be served by sewers? Yes___ No___ By septic system? Yes___ No___

Is any part of the property within:

100 feet of an Inland Wetland or Water Course? Yes____ No____

FEMA Flood Zone? Yes____ No____

CT Coastal Management Act Coastal Boundary? Yes____ No____

Town Center Review Area? Yes____ No____

Water Supply Watershed? Yes____ No____

500 feet of an adjoining town? Yes____ No____

Does property abut a State Highway? Yes_____ No_____

APPLICANT:________________________________ DATE:________(Please print or type.)

FOR OFFICE USE ONLY

Route to: Date Referred: Comments (date returned)
___Wetlands Officer ___________ ______________________________
___Engineering Department
      flood/sewer/driveway/grading ___________ ______________________________
___East Shore District Health Dept. ___________ ______________________________
___Town Center Review Board ___________ ______________________________
___So. Central Regional COG ___________ ______________________________
___DEP Coastal ___________ ______________________________
___Regional Water Authority ___________ ______________________________
___Town Clerk of
      Guilfd./ E. Haven/ No.Bfd.

___________

______________________________
___CT DOT ___________ ______________________________



Online Link to List of Forms (ignore on printed copy)

Submit completed form to
PLANNING AND ZONING COMMISSION
TOWN OF BRANFORD
1019 Main Street
P.O. Box 150
Branford, CT 06405
Telephone: 203-488-1255
FAX: 203-481-5561