HomeMy WebLinkAbout20180204 18.017 HydestreetSubd_Water Service AgreementCity of Saratoga Springs
OFFICE OF PUBLIC WORKS
5 Lake Avenue
Saratoga Springs, New York 12866
Phone 518-587-3550 ** Fax 518-587-2417
vvww.saratoga-springs.org
NEW WATER SERVICE CONNECTION
AGREEMENT & APPLICATION FORM
ANTHONY J. SCIROCCO
COMMISSIONER
FRANK COPPOLA, JR.
DEPUTY COMMISSIONER
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Property Owner's Name: A N (-to i� J)1 3 C Project Name (if applicable): c St
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Tax Map#: (DS ,.1-3 - a- x-1.1_ i
Property Address: ft% ? i Sf
Size of Tap (check one below):
3/�!! ❑ 1"
Number of Dwellings: 3
❑ Greater than 1"
A unit of water shall be defined as fourteen thousand (14,000) cubic feet
of water per year.
Contact the Water Dept at ext. 2502 for assistance with water
use estimation and meter specifications before signing below.
Estimated Cubic Feet of Water per Year:
To be completed in full without any contingencies or protest, on or before the Building Inspector approval of the rough plumbing,
including the installation of the water meter, or, at the time of the issuance of a tapping permit.
The undersigned represents to the City that they have full and complete authority to execute this document and find and commit the
developer to abide by the City Water Ordinance. This agreement shall be binding on all of the undersigned transferees.
The undersigned acknowledg - that . copy
f this document will be delivered to all appropriate and necessary governmental entities.
Authorized Signature: � �� •t • Company Name: Will-
ISS Cfi on) +1 �(
Company Address: ') , groG c 1(Cara . SO. r ,c) N"� 12.2Npie
Phone Number: (7 i 61-31 - 113 Fax Number: Date: 65 I22 ( 20 tS
Department of Public Works Approval: Date: