VII. Site Plan
Illustrate the following information about your lot and the proposed use of the lot on a scale drawing or by a site plan prepared by a surveyor, architect, or engineer (use of graph paper as in the diagram to the right is recommended):
  1. Lot dimensions
  2. Names of abutting property owners, name and location of abutting rights of way, public and private, and abutting water body.
  3. - Show location of proposed construction in relation to shoreline. Label distance in feet.
    - Show location of proposed construction in relation to all lot lines. Label distances in feet.
    - Show location of proposed construction in relation to existing buildings. Label distances in feet.
    - If the proposed construction is an addition to an existing structure, also show location of the existing structure to all lot lines and to the shore. Label distances in feet.
  4. Location of sewage disposal system and water supply.
  5. Areas to be cleared, if applicable.
  6. Areas of cut, fill, grading, or other earth moving activity, if applicable.
  7. Attach a copy of Plumbing Permit.
  8. Attach a copy of official decisions (or note pending applications) of other Federal, State, or local agencies regarding the use of this property (Site Location Permit, Minimum Lot Size waiver, Subdivision approval, Great Ponds Permit, etc.)
  9. On a separate sheet, attach any supplemental information, or explain any points you feel need clarification.
To the best of my knowledge, all information submitted on this application is true and correct. All proposed uses will be in conformance with the application and the __________________________________ (zoning ordinance.)
Signature __________________________________ Date _______________
(For official use only - maintain as a permanent record)
Date Received _______________ Fee Paid ____________________
Date of Action on Application _________ Approved _____ Denied _____
If application denied, reason for denial _______________________________
If approved, the following conditions and safeguards were prescribed: ________
Code Enforcement Officer (if applicable) ______________________________
Signed & Dated _________________________________________________
Notification of Intention to Build - page 2 of 3

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