HomeMy WebLinkAbout20181047 18.056 62-64 Excelsior_Water ServiceCity of Saratoga Springs
OFFICE OF PUBLIC WORKS
5 Lake Avenue
Saratoga Springs, New York 12866
Phone 518-587-3550 ** Fax 518-587-2417
www. sa ratoga -s p ri n gs. o rg
NEW WATER SERVICE CONNECTION
AGREEMENT & APPLICATION FORM
ANTHONY J. SCIROCCO
COMMISSIONER
TIMOTHY J. COGAN
DEPUTY CONLNIISSIONER
RR Depot LLC 62 64 Excelsior Ave
Property Owner's Name: Project Name (if applicable):
62-64 Excelsior Ave
Property Address:
Size of Tap (check one below):
F134,, A "
Number of Dwellings:
Tax Map#: 166.29-3-32
reater than 1"
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: 629/ 8=1O0
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 acknowledges tha 4copy of this document will be delivered to all appropriate and necessary governmental entities.
Authorized Signature: — Company Name:
RR Depot LLC
18 u1 ision Street, Suite 401, Saratoga Spring
Company Address:
Phone Number:
518.5 4.9007 Fax Number: Date: 10/5/52018
Department of Public Works Approval: Date: