CITY OF NORWALK MOTOR VEHICLE LICENSE APPLICATION FORM March 30, 2015

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CITY OF NORWALK MOTOR VEHICLE LICENSE APPLICATION FORM March 30, 2015 FEE: MOTOR VEHICLE LICENSE $510.00 Fee Paid: (NOTE: Payment of this application fee must be made by credit or debit card only; cash and checks are not accepted. Fee includes $60 for State of Connecticut land use processing fee) Application for: ( ) Motor Vehicle Repairer License ( ) Motor Vehicle Dealer License Ten copies of this application must be filed with a check for above fee payable to "Treasurer - City of Norwalk", four (4) copies of Class A-2 Survey showing all buildings - existing and proposed; and 4 sets of dimensioned site plans or architectural plans if any interior or exterior improvements are proposed. Answer all questions fully using separate sheet if necessary. Please read instructions carefully. All applications and supplemental information sheets must be typed. APPLICANT(S) NAME:, 20 ADDRESS: TEL. # FAX # LOCATION OF OPERATION TO BE LICENSED: (Street Address) DATE ACQUIRED: OWNER S NAME: (If other than applicant) OWNER S ADDRESS: PLATE DIST. BLOCK LOT ZONE FL. ELEV. CAM 1. IF APPLICANT IS NOT THE OWNER, STATE APPLICANT'S INTEREST. 2. WHAT PREVIOUS APPLICATION(s) HAVE BEEN MADE FOR THIS PROPERTY, including prior applications to Zoning Board of Appeals. (Give prior o name, w address, phone number, type of license and other details). 3. DOES PROPERTY CONTAIN WETLANDS OR A WATERCOURSE? -2-

4. If a public hearing is required, it is the Applicant's responsibility to notify all adjoining property owners including those across the street (see attached Notification Instructions). List the name and mailing address of such owners. I HEREBY CERTIFY THAT ALL OF THE STATEMENTS HEREIN CONTAINED ARE TRUE AND CORRECT. Applicant's Signature Property Owner s Signature (FOR STAFF USE ONLY) COMMITTEE REVIEW DATE: PUBLIC HEARING DATE (if required): COMMISSION ACTION DATE: EFFECTIVE DATE: GRANTED ( ) GRANTED W/CONDITIONS ( ) DENIED ( ) (Staff signature) Approved by Zoning Commission July 19, 2006, effective January 31, 2008. As revised March 30, 2015 to revise payment options

-3- Notification of Neighbors APPLICATION NOTIFICATION INSTRUCTIONS Applications which require a Public Hearing shall comply with the following notice requirements: The Applicant shall notify by certified mail, return receipt requested at least ten (10) days prior to the public hearing, the owners of land which abut or are directly across the street from the subject parcel. The names and addresses of the owners shall be obtained by the Applicant in person from the latest Tax Assessor records. When a condominium is located across the street, or abuts the subject proposal, notification may be sent to the condominium association in lieu of the individual unit owners. Evidence of certified mailings shall be submitted by the Applicant at the public hearing. Notification Form to be used: Dear Be advised that property Applicant name has applied for a Motor Vehicle License for located at the following address:. Street name and number and District, Block and Lot number The proposal is for Description of proposal. The Norwalk Zoning Commission will conduct a Public Hearing on this proposal on the Day, Date, Time in Common Council Chambers, Norwalk City Hall. You are being notified because your property abuts or is located directly across the street from the subject parcel. The application is on file in the Planning and Zoning Commission Office, City Hall, 125 East Avenue, Norwalk, Connecticut, 06856-5125.

IMPORTANT NOTICE TO ALL APPLICANTS FOR MOTOR VEHICLE LICENSE EFFECTIVE January 31, 2008 DUE TO RECENT CHANGES IN THE CT. GENERAL STATUTES, THE ZONING COMMISSION WILL REVIEW REQUESTS FOR CERTIFICATE OF APPROVAL OF THE LOCATION FOR ALL MOTOR VEHICLE DEALERS & REPAIRERS: 1. ALL APPLICATIONS MUST BE TYPED INCLUDING ANY SUPPLEMENTARY INFORMATION & INCLUDE CORRECT FEE 2. ALL BLANKS MUST BE ACCURATELY COMPLETED, AND ALL QUESTIONS ACCURATELY ANSWERED; 3. TEN (10) COPIES OF COMPLETED APPLICATION FORM; 4. ORIGINAL STATE DEPARTMENT OF MOTOR VEHICLES K-7 FORM 5. FOUR (4) COPIES EACH OF; A. CLASS A-2 SURVEY (WITH APPLICABLE INFO); B. AREA SURVEY SHOWING PROXIMITY TO SCHOOLS, HOSPITALS, CHURCHES, THEATERS & LIBRARIES AS PER SECTION 118-1010 C. DIMENSIONED, SCALED FLOOR PLAN AND ELEVATION GENERAL ARRANGEMENT DRAWINGS OF EXISTING & PROPOSED CONSTRUCTION (AS APPLICABLE); MUST BE PROVIDED. ALL EXHIBITS MUST BE FOLDED TO APPROXIMATELY 8 1/2 X 11-INCH SIZE. 5. OPERATOR(S) OF ANY PROPOSED MOTOR VEHICLE ENTERPRISE AND THE OWNER(S) OF THE PROPERTY WHERE THE BUSINESS IS PROPOSED MUST BOTH APPEAR AT ANY ZONING COMMISSION MEETINGS AND BE PREPARED TO GIVE TESTIMONY AS THE COMMISSION MAY REQUIRE. NOTE: FAILURE TO COMPLY WITH THIS REQUIREMENT MAY RESULT IN THE POSTPONEMENT OF COMMISSION ACTION ON THE MOTOR VEHICLE LICENSE. 6. PAYMENT FOR LEGAL NOTICE PUBLICATION: WHERE A PUBLIC HEARING IS REQUIRED, APPLICANTS SHALL BE RESPONSIBLE FOR PAYMENT OF THREE LEGAL NOTICES IN THE HOUR NEWSPAPER. TWO NOTICES WILL ADVERTISE THE APPLICATION S PUBLIC HEARING DATE AND ONE WILL ADVERTISE THE COMMISSION S ACTION ON THE APPLICATION. THE P&Z STAFF WILL PROVIDE THE REQUIRED LEGAL NOTICES TO THE HOUR. APPLICANTS MUST CONTACT THE HOUR AT THE ADDRESS GIVEN BELOW TO ARRANGE FOR PAYMENT IN ADVANCE OF THE PUBLICATION DATE. CLASSIFIED ADVERTISING MANAGER THE HOUR 346 MAIN AVENUE NORWALK, CT 06851 Phone: (203) 846-3281 Fax: (203) 846-9897

SUPPLEMENT TO APPLICATION FOR CERTIFICATE OF APPROVAL FOR MOTOR VEHICLE DEALERS OR REPAIRERS LICENSE APPLICANT: LOCATION: TYPE OF LICENSE: Check applicable spaces to indicate operations that will be performed: SALES New cars Used cars New trucks Used trucks New motorcycles Used motorcycles Motor homes OTHER Towing SERVICES Body manufacture Body repair General mechanical repairs Electrical repairs Tire repairs Upholstering Glazing Welding Painting Cooling system repairs Fuel system repairs Exhaust system repairs Brake adjustment, relining & repairs Wheel alignment & balancing Shock absorbers Repair & replacement Spring replacement & adjustment List below any work to be performed not listed above: Applicant(s) signature

Property Owner(s) signature