Property Owner:
Name
Address
Town		Zip		Tel

Applicant:
Name
Address
Town		Zip		Tel

Contractor:
Name
Address
Town		Zip		Tel

Location of property (street):

Existing use of property:

If the structure is a new dwelling, is it manufactured housing?:

Yes   No

Proposed use of property/project description

Type of sewage disposal:	Existing:	Town	Septic	Other
	Proposed:	Town	Septic	Other

Number of bedrooms:

Existing:

Proposed:

Year round use

Seasonal use only

Type of water supply:
	Town	Well	Other

Lot dimensions:	Road frontage:		Depth:		Area:
(If lot has no road frontage and is accessible only by Right-of-Way, include a copy of the R.O.W. deed description with this application.)

Number of dwelling units presently existing on the lot:   

Proposed structures: Exterior dimensions (width x length):
Principal:	x	No. stories:
Accessory:	x	No. stories:

Is project site or proposed use located within a Floodplain?

Yes

No

Estimated Fair Market Value of proposed project upon completion, including materials and labor: $

If structure is a mobile home, where is it being moved from?

On a separate sheet, submit a site plan as illustrated below, as well as any supplemental information or explanations you feel necessary.

To the best of my knowledge, all information submitted on this application is true and correct. All proposed uses will be in conformance with this application and the Wilton Zoning Ordinance. Signature:   Date:

(Click here for a sample site plan requirements and sample drawing)