HomeMy WebLinkAbout20210415 Driscoll Road Site Plan New Water Service Agreement City of Saratoga Springs
w+ Department of Public Works
A Anthony J. Scirocco
T rr 15 Vanderbilt Avenue ( mpora�y address) Commissioner
- ` :_r U Saratoga Springs, NI 12866
(518) 587-3550 office Joseph J. O'Neill
u'ww.saratoga-springs.org Deputy Commissioner
NEW WATER SERVICE CONNECTION
AGREEMENT & APPLICATION FORM
Property Owner's Name Susan Sikule Project Name (if applicable) 1 Driscoll Road
Property Address 1 Driscoll Road Tax Map #: 191.-1-2.5
Size of Tap (check one below)
s/. " 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: 1 Estimated Cubic Feet of Water per Year 300±
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 Susan Sikule
Company Name &Address Driscoll Road LLC, 2075 Western Ave. Guilderland, NY 12084
Company Phone Number 518-869-5779 Fax Number N/A Date 8/4/2021
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Department of Public Works Approval Date: