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HomeMy WebLinkAbout2018-02-20 Application LDP d9 3 2 PLANNING DEPARTMENT Community&Economic Development Division Land Disturbance Permit AEplication LL Please type or print clearly. 1.Petitioner: C' ; ,;�; I-Jiio!Ii Petitioner's Address. Telephone number: c► 2.Owners of the Land; ►t�� a ,�-^y , Addresst as , Number of years of ownership: ` tl R � 3.Address of Property Being Affected:� 10ir604- i- --- ~`�- Zoning District: _Lot Assessors Map: page#: 6 Registry of Deeds:Book#: 2.3d 9 4.Description of Project: -, el 5.Total Area to be Disturbed Q? S 6® `� 6.Has there been a previous application(Special Permit or Definitive Subdivision)from the Planning Board on these premises? If so,when and for what type of construction? 7.Has there been a previous application(N©URDA,Small Project,Certificat Ife of Compliance hen what type? )from the Conservation Commission on thew iprrem es? � 8.Petitioner and Landowner signature(s): Every application for a Land Disturbance Permit shall be made on this form, which is the official form of the Planning Board. Every application shall be filed with the Town Clerks office. it shall be the responsibility of the petitioner to furnish all supporting documentation with this application.The dated copy of this application received by the Town Clerk or Planning office does not absolve the Page 1 of 2 120 Main Street,Planning Dept.,North Andover,Massachusetts 01845 Phone 978.688.9535 Fax 978.688.9542 Web www northandoverma.aov applicant from this responsibility. The petitioner shall be responsible for all expenses for filing and legal notification. Failure to Comply With aPplic ' n requirements, as cited herein and in the Planning Board Rules and Regulations may r 'rin a dismissal by the Planning Board of this application as incomplete. Petitioner's Signature: Print or type name here,. e9 as -a CIA 0- Owner's Signature: Print or type name here: 9. Please list title of plans and documents you will be attaching to this application. fl?l C W 0 4- Page 2 of 2 120 Main Street,Planning Dept.,North Andover,Massachusetts 01845 Phone 978.688-9535 Fax 978.688.9542 Web Mff—.n0—rth-a—nd-0V—er—M—a.q-0v Carol R. Resca 865 Johnson Street North Andover, MA 01845 Planning Department Town of North Andover 120 Main Street North Andover, MA 01845 December 7, 2017 RE• Owner Certification of authorized Applicant for Land Disturbance Permit, Mill RdJJohnson St. Dear Planning Department: This correspondence is to satisfy section 6.1 of the North Andover Stormwater Management Regulations in support of the Land Disturbance Permit application for Mill Road and Johnson Street Lots 1 A, 1 B, 2A&213. As owner of this property I authorize TKZ LLC and/or Thomas D. Zahoruiko to apply for the aforementioned permit, and to submit documents and plans and act on my behalf regarding this application and permit process. Carol R. Resca Date