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TOWN OF EAST HARTFORD
DEPARTMENT OF DEVELOPMENT
740 Main Street, 2nd Floor
East Hartford, Connecticut 06108
Phone: 860-291-7300

DIGITAL DATA AFFIDAVIT FORM
Accompanying this form shall be four (4) prints and one (1) digital copy of the Planning and Zoning Commission approved
plans submitted pursuant to the requirements of Section 705.2.c of the Zoning Regulations.

DATE:

PLANS SUBMITTED BY (NAME & CONTACT):

PROJECT NAME:
PROJECT ADDRESS:
PLANNING AND ZONING COMMISSION APPROVAL DATE:
APPLICATION TYPE:

SPECIAL PERMIT

SITE PLAN

(CHECK ALL THAT APPLY)

FLOOD HAZARD MAJOR

SITE PLAN MODIFICATION SITE LOCATION

FLOOD HAZARD MINOR

SOIL E&S CONTROL PLAN

OTHER (SPECIFY)
PLAN CONTENTS:
PLAN TITLE:
NO. OF SHEETS:

FINAL REVISION DATE:

OTHER DOCUMENTS:

DESIGN PROFESSIONALS: SIGNATURES & STAMPS*
DESIGN FIRM

PRINT NAME

SIGNATURE

SEAL

1.

SEAL
2.
*By signing and stamping this affidavit, and in accordance with Section 20-300-10 of the Regulations of Connecticut
State Agencies, I