Town of Greenwich Signature required
Planning & Zoning Department Type online, print & sign
Town Hall – 101 Field Point Road, Greenwich, CT 06830-2540
Phone: (203)622-7894 – Fax: (203)622-3795
SITE PLAN ADMINISTRATIVE FORM
PLPZ# __________________________________ PZAdminSitePlan 01/01/2013
Accessory Apartment, Elderly
Accessory Apartment, Affordable
Site Plan Signoff
Architectural Review Committee
Drainage / Driveway
Coastal Site Plan
Landscape / Tree Planting
Subdivision Lot
Soil Erosion and Sedimentation
Utility or Telecommunications
Facility
Other ______________________
Owners Name: __________________________________ Signature: _______________________________
Agent Name/ Tel. no. _______________________________________________________________
Address of Property ________________________________________________________________
Parcel ID# _____________________________
Lot Size ____________ B) Property Zone ____________ C) Flood Zone ___________ ZEO Init. ________
Check if legally conforming: Lot Area Setbacks FAR _________________
Description of Activity or Work Proposed : ____________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
Previous Review/Approvals by P&Z (Date And Number) __________________________________________
Other Land Use reference #. (IWWCA, Coastal Site Plan, Affordable, Elderly) _________________________________
Total Building Square Footage (or total site work area):
Present Use ________________________________ Square Footage ___________________
Proposed Use ______________________________ Square Footage ___________________
For staff use only:
Reviewed by:
Town Planner _______________________________ Senior Planner _________________________________
Asst. Town Planner _______________________________ Planner __________________________________
(2 signatures required- one must be Town Planner as per §6-13; Town Planner may waive full Commission review of small scale
projects but require approval of ARC where appropriate.)
See attached Conditions of Approval
Per § 6-14.1(e) of BZR, approval is valid for 3 years only; and work must be completed in 5 years from issuance of permit, per State
Statute.
Check # _________________ Check Amount: $__________