HomeMy WebLinkAbout20210757 Myrtle Street Site Plan Water Service Agreement City of Saratoga Springs
', Department of Public Works
15 Vanderbilt Avenue (temporary address Anthony J. Scirocco
Commissioner
;'\ `" Saratoga Springs, NT 12866
"°-'PORATEo (518) 587-3550 office Joseph J. O'Neill
www.saratoga-springs.org Deputy Commissioner
NEW WATER SERVICE CONNECTION
AGREEMENT & APPLICATION FORM
Property Owner's Name Saratoga Hospital _ Project Name (if applicable) Myrtle St Medical Office Campus
Property Address 1 Morgan Street, 55 Myrtle St Tax Map#: 165.-1-37.2, 165.-1-37.1
Size of Tap (check one below)
3/4 " 1" X Greater than 1"
A unit of water shall be defined as 14,000 (fourteen
thousand) cubic feet of water per year.
Contact the Utilities Department at ext. 2502 for
assistance with water use estimation and meter
specifications before signing below.
Number of Dwellings: Estimated Cubic Feet of Water per Year 264,367
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 that a copy of this document will be delivered to appropriate and necessary
governmental entities.
Authorized Signature Print Name
Company Name&Address Saratoga Hospital 211 Church St, SS, NY 12866
Company Phone Number 518-581-3222 Fax Number Date
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Department of Public Works Approval Date: