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Home My WebLink About20211023 235 Nelson Area Variance Application **HANDWRITTEN APPLICATIONS WILL NOT BE ACCEPTED** IFOROFFICE USEl c2R� V0GF] rd� CITY OF SARATOGA SPRINGS (Application#) f CI) .1 ZONING BOARD OF APPEALS CITY HALL-474 BROADWAY (Date received) f- gir ? SARATOGA SPRINGS, NEW YORK 12866-2296 °ao . TEL: 518-587-3550 X2533 . *op =3\`',9``' www.saratoga-springs.org (Project Title) APPLICATION FOR: INTERPRETATION, USE VARIANCE, Check if PH Required 1-1 AREA VARIANCE AND/OR VARIANCE EXTENSION Staff Review APPLICANT(S)* OWNER(S) (if not applicant) ATTORNEY/AGENT Name Rachel & Dyllan Beck Frost Hurff Architects Address 235 Nelson Ave 41 Long Alley Saratoga Springs, NY Saratoga Springs, NY Phone (518)429-3829 / / (518)584-7514 / Email racheleisenhauer@gmail.com abby@fharch.com Primary Contact Person: DApplicant [Owner Attorney/Agent *An applicant must be the property owner, lessee,or one with an option to lease or purchase the property in question. Applicant's interest in the premises: 0 Owner 0 Lessee 0 Under option to lease or purchase PROPERTY INFORMATION I. Property Address/Location: 235 Nelson Ave Tax Parcel No.: 166 .53 - 1 _ 36 (for example: /65.52-4—37) 2. Date acquired by current owner: 03/2021 3.Zoning District when purchased: UR-3 4. Present use of property: Primary Residence 5. Current Zoning District: UR-3 6. Has a previous ZBA application/appeal been filed for this property? ❑Yes (when? For what? ) 0 No 7. Is property located within (check all that apply)?: 0 Historic District 0 Architectural Review District 0 500' of a State Park,city boundary,or county/state highway? 8. Brief description of proposed action: An addition consisting of garage space, sunroom, office and master suite shall be construction on the rear of the property. 9. Is there an active written violation for this parcel? 0 Yes 0 No 10. Has the work, use or occupancy to which this appeal relates already begun? ❑Yes ®No 11. Identify the type of appeal you are requesting(check all that apply): ❑ INTERPRETATION (p.2) 0 VARIANCE EXTENSION (p.2) 0 USE VARIANCE (pp. 3-6) 0 AREA VARIANCE(pp. 6-7) Revised 01/2021 ZONING BOARD OFAPPEALSAPPLICATION FORM PAGE INTERPRETATION—PLEASE ANSWER THE FOLLOWING(add additional information as necessary): I. Identify the section(s)of the Zoning Ordinance for which you are seeking an interpretation: Section(s) 2. How do you request that this section be interpreted? 3. If interpretation is denied,do you wish to request alternative zoning relief? EYes ❑No 4. If the answer to#3 is"yes,"what alternative relief do you request?❑ Use Variance 0 Area Variance EXTENSION OF A VARIANCE—PLEASE ANSWER THE FOLLOWING(add additional information as necessary): I. Date original variance was granted: 2. Type of variance granted? 0 Use 0 Area 3. Date original variance expired: 5. Explain why the extension is necessary.Why wasn't the original timeframe sufficient? When requesting an extension of time for an existing variance,the applicant must prove that the circumstances upon which the original variance was granted have not changed. Specifically demonstrate that there have been no significant changes on the site, in the neighborhood,or within the circumstances upon which the original variance was granted: Revised 01/2021 ZONING BOARD OFAPPEALSAPPLICATION FORM PAGE USE VARIANCE—PLEASE ANSWER THE FOLLOWING(add additional information as necessary): A use variance is requested to permit the following: For the Zoning Board to grant a request for a use variance, an applicant must prove that the zoning regulations create an unnecessary hardship in relation to that property. In seeking a use variance,New York State law requires an applicant to prove all four of the following "tests". I. That the applicant cannot realize a reasonable financial return on initial investment for any currently permitted use on the property. "Dollars&cents"proof must be submitted as evidence.The property in question cannot yield a reasonable return for the following reasons: A. Submit the following financial evidence relating to this property(attach additional evidence as needed): I) Date of purchase: Purchase amount: $ 2) Indicate dates and costs of any improvements made to property after purchase: Date Improvement Cost 3)Annual maintenance expenses:$ 4)Annual taxes:$ 5)Annual income generated from property:$ 6)City assessed value: $ Equalization rate: Estimated Market Value:$ 7)Appraised Value:$ Appraiser: Date: Appraisal Assumptions: Revised 01/2021 ZONING BOARD OFAPPEALSAPPL/CAT/ON FORM PAGE 4 B. Has property been listed for sale with EYes If"yes",for how long? the Multiple Listing Service(MLS)? [ONo I)Original listing date(s): Original listing price:$ If listing price was reduced,describe when and to what extent: 2) Has the property been advertised in the newspapers or other publications? ❑Yes ❑No If yes,describe frequency and name of publications: 3) Has the property had a"For Sale"sign posted on it? ❑Yes ❑No If yes, list dates when sign was posted: 4) How many times has the property been shown and with what results? 2. That the financial hardship relating to this property is unique and does not apply to a substantial portion of the neighborhood. Difficulties shared with numerous other properties in the same neighborhood or district would not satisfy this requirement. This previously identified financial hardship is unique for the following reasons: Revised 01/2021 ZONING BOARD OFAPPEALSAPPLICATION FORM PAGE 5 3. That the variance, if granted, will not alter the essential character of the neighborhood. Changes that will alter the character of a neighborhood or district would be at odds with the purpose of the Zoning Ordinance. The requested variance will not alter the character of the neighborhood for the following reasons: 4. That the alleged hardship has not been self-created.An applicant(whether the property owner or one acting on behalf of the property owner)cannot claim "unnecessary hardship" if that hardship was created by the applicant,or if the applicant acquired the property knowing(or was in a position to know)the conditions for which the applicant is seeking relief.The hardship has not been self-created for the following reasons: Revised 01/2021 ZONING BOARD OFAPPEALSAPPLICATION FORM PAGE 6 AREA VARIANCE—PLEASE ANSWER THE FOLLOWING(add additional information as necessary): The applicant requests relief from the following Zoning Ordinance article(s) Article II Dimensional Requirements District Requirement Requested Lot Coverage 30% 37.2% Other: To grant an area variance,the ZBA must balance the benefits to the applicant and the health,safety,and welfare of the neighborhood and community,taking into consideration the following: I. Whether the benefit sought by the applicant can be achieved by other feasible means. Identify what alternatives to the variance have been explored (alternative designs,attempts to purchase land,etc.)and why they are not feasible. The a••licant seeks to build an attached s arae with livin' s•ace above.If the a••licant were to detach the arae the project would meet lot coverage requirements,but a variance would still be required for living space in an accessory structure.Regardless,the use sought for the upper story is a bedroom,which will only provide the benefit sought if it is attached to the main residence,necessitating the relief applied for. 2. Whether granting the variance will produce an undesirable change in the character of the neighborhood or a detriment to nearby properties. Granting the variance will not create a detriment to nearby properties or an undesirable change in the neighborhood character for the following reasons: If the relief is granted,the total building will still be of a mass,scale,and use consistent with the adjoining properties. While the garage will be attached,access to it will be off the alley in a use pattern typical of the neighborhood.No driveways or garage doors will be visible from Nelson Avenue. Revised 01/2021 ZONING BOARD OFAPPEALSAPPLICATION FORM PAGE 7 3. Whether the variance is substantial. The requested variance is not substantial for the following reasons: Although the proposed lot coverage for the principal structure is 7.2% more than the permitted limit,much of that coverage is dedicated to a typical accessory use (garage),and the total lot coverage does not exceed the allowed limits.As part of the conditions of relief,the applicant would be willing to waive any right to developing accessory structures that cover more than 2.8% of the lot without review by the Zoning Board of Appeals. 4. Whether the variance will have adverse physical or environmental effects on neighborhood or district. The requested variance will not have an adverse physical or environmental effect on the neighborhood or district for the following reasons: The proposed project will not change the density,permeability,lighting,drainage or any other physical attribute of the neighborhood and zone beyond common practice and the accepted standards of the ordinance. 5. Whether the alleged difficulty was self-created(although this does not necessarily preclude the granting of an area variance).Explain whether the alleged difficulty was or was not self-created: The difficulty is self-created. Revised 01/2021 ZONING BOARD OFAPPEALSAPPL/CAT/ON FORM PAGE 8 DISCLOSURE Does any City officer,employee,or family member thereof have a financial interest(as defined by General Municipal Law Section 809)in this application? 0 No 0 Yes If"yes",a statement disclosing the name,residence and nature and extent of this interest must be filed with this application. APPLICANT CERTIFICATION I/we,the property owner(s),or purchaser(s)/lessee(s) under contract,of the land in question, hereby request an appearance before the Zoning Board of Appeals. By the signature(s)attached hereto, I/we certify that the information provided within this application and accompanying documentation is,to the best of my/our knowledge,true and accurate. I/we further understand that intentionally providing false or misleading information is grounds for immediate denial of this application. Furthermore, I/we hereby authorize the members of the Zoning Board of Appeals and designated City staff to enter the property assi ed with this application for purposes of conducting any necessary site inspections relating to this appeal. Date: 10/15/21 iiii plicant signature) - .- , ,._, ---: ,� Date: 10/15/21 (app cant' nature) If applicant is not the currently the owner of the property,the current owner must also sign. Owner Signature: Date: Owner Signature: Date: Revised 01/2021 N10G4 � CITY OF SARATOGA SPRINGS tv. • ZONING BOARD OF APPEALS `' O v— C:4 -y HaLL - 474 13tratw(-vay • .,. .^r Sarab-o-ga Sprim-rimNe-w-Yo-trki 12S 6 TO). 512-527-3550 X2533 °0'5'PaRA-vn `9 www:sa-trcgaga--spri,vtgyorg INSTRUCTIONS APPEAL TO THE ZONING BOARD FOR AN INTERPRETATION, USE VARIANCE,AREA VARIANCE AND/OR VARIANCE EXTENSION APPLICATION REQUIREMENTS 1. ELIGIBILITY:To apply for relief from the City's Zoning Ordinance, an applicant must be the property owner(s) or lessee, or have an option to lease or purchase the property in question. The Zoning Board of Appeals (ZBA) shall not accept any application for appeal that includes a parcel which has a written violation from the Zoning and Building Inspector that is not the subject of the application. 2. COMPLETE SUBMISSIONS: Applicants are encouraged to work with City staff to ensure a complete application. The ZBA will only consider properly completed applications that contain 1 original and 1 digital version of the following: ❑ Completed application pages I and 8, the pages relating to the requested relief(p. 2 for interpretation or extension, pp. 3-5 for use variance, pp. 6-7 for area variance), and any additional supporting materials/ documentation. **HANDWRITTEN APPLICATIONS WILL NOT BE ACCEPTED** ❑ Completed SEQR Environmental Assessment Form —short or long form as required by action. http://www.dec.ny.gov/docs/perm its_ej_operations_pdf/seafpartone.pdf ❑ Detailed "to scale" drawings of the proposed project—folded and no larger than 24"x 36". Identify all existing and proposed structures, lot boundaries and dimensions, and the relationship of structures to the lot dimensions. Also, include any natural or manmade features that might affect your property (e.g., drains, ponds, easements, etc.). ❑ Photographs showing the site and subject of your appeal, and its relationship to adjacent properties. 3. APPLICATION FEE (NON-REFUNDABLE): Make checks payable to the "Commissioner of Finance". REFER TO THE CURRENT FEE WORKSHEET INCLUDED IN THIS DOCUMENT. Check City's website (www.saratoga-springs.org) for meeting dates. Revised 01/2021 ZONING BOARDAPPEAL APPLICATION INSTRUCTIONS PAGE PUBLIC HEARING ADVERTISEMENT The Zoning Board of Appeals is required to hold a public hearing on each submitted application within ninety(90) days from when it is determined to be properly complete by City staff. City staff will prepare a legal notice for the public hearing and arrange to have the public hearing announcement printed in the legal notice section of a local publication at least 5 days before the hearing. PROPERTY OWNER NOTIFICATION Applicants are required to mail a copy of the public hearing legal notice to all property owners within the following distances from the boundaries of the land in question: Type of variance Distance for property owner notification Use variance 250 feet Area variance & Interpretation 100 feet This notice must be sent at least 7 days but not more than 20 days before the date of the public hearing. City staff will email a copy of the"property owner notification letter"to the applicant.The applicant must then send the notification letter to the nearby property owners.Applicants may not include any other materials in this mailing. The mailing must be certified by the U.S. Post Office. Prior to the public hearing,applicants must present the Post Office "certificates of mailing" to the ZBA. If"certificates of mailing" are not presented prior to the hearing, the hearing will be cancelled. Revised 01/2021 2021 LAND USE BOARD FEE WORKSHEET OPED Fees Type 2021 Fee Application to Zoning Board of Appeals[1][2] TOTAL #VARIANCE Use Variance $1100+$50/app Area Variance-Residential $275/var+$50/app+$125 eachadd'I variance Area Variance-Multi-Family,Comm,Mixed-Use $660/var+$50/app+$200 eachadd'I variance Interpretations $550+$50/app Post-Work Application Fee Add 50%App fee+$50/app Variance extensions 50%ofApp fee+$50/app Application to Design Review Commission[1] TOTAL #STRUCTURE Demolition I $385 Residential Structures Principal $55 Accessory $55 Extension $35 Modification $55 Multi-Family,Comm,Mixed-Use Structures Sketch $165 Principal $550 Extension $200 Modification $330 Multi-Family,Comm,Mixed-Use Accessory,Signs,Awnings Principal $140 Extension $75 Modification $140 Post-Work Application Fee Add 50%App fee Application to Planning Board[1] TOTAL #STRUCTURE Special Use Permit[2] $990+$50/app Special UsePermit-extension $330 Special UsePermit-modification[2] $450+$50/app Site Plan Review-incl.PUD: Sketch Plan $330 Residential $330+$200/unit Residential-extension $200 Residential-modification $400 Non-residential $660+$130/1000 sf Non-Residential-extension $300 Non-Residential-modification $650 Subdivision-incl.PUD: TOTAL #LOTS Sketch Plan I $330 Preliminary Approval[2] Residential:1-5 lots $660+$50/app Residential:6-10 lots $990+$50/app Residential:11-20 lots $1320+$50/app Residential:21+lots $1650+50/app Residential-extension $330 Final Approval[2] Residential $1320+$175/lot+$50/app Non-Residential $2000/lot+$50/app Final Approval Modification[2] Residential $330+$50/app Non-Residential $550+$50/app Final Approval Extension Residential $135 Non-Residential $330 Other: TOTAL #LOT/ACRE Post-Work Application Fee Add 50%App fee Lot Line Adjustment $350 Letter of Credit-modification or extension $440 Letter of Credit-collection up to 1%ofLoC Recreation Fee $2000/lotorunit Land Disturbance $660+$55/acre SEQRA EIS Review(Draft&Final) TBD Legal Noticing if PB requires Public Hearing $50/app [1] Fees are based on per structure,except where noted. $0.00 TOTAL DUE [2] Legal ad required;includes City processing and publishing For Administrative Use Total Paid at Intake Revised Fee Balance Due / / Balance Paid Staff approval FROS' 1 HURFF ARCHITECTS 41 Long Alley, Saratoga Springs, NY 12866 235 Nelson Avenue Site Photos East elevation viewed from Nelson Ave. 'i r..,, :.'• ,a --r - yas . r,— Cyt ��:.. xx ' •-.,ir,-...,-' - .r...1 ..„,... L - . =- fir: . �y South elevation obscured by plantings. %, .. ,- . "Ilpetv. *. 4 ..,,.'L- :,.. fl -1 1 FROS' 1 HURFF ARCHITECTS West elevation viewed from Diamond Pl. r 01 01 .- Pi West elevation relationship to adjoining properties alon2 Diamond Pl. 1 v 3 11 ::; \ s e _ - f �: • } 2 FROS' 1 HURFF ARCHITECTS North elevation viewed from Diamond Pl. ---7------- - j:,----,--- :-, =— 1 I,—:- I Lusi-o • 9 3 1 1 --1 i i i I0 44 ' ..- 111/ J� � i � �I uI,I A\°°\\ �i ISI illie°/ 55,oZo\ - oio * %/ 5 k r ' p 106 ,p_ 4, IsI% �IsI — — N; ________ -. ROOF LINE (TYP.) ,---' j �I hI%I w ''d --- h , ID 0 • %I z v� o I,I i �I�I w , ,_,. D C ril - ---- ...._ ,__ % -' I ISI E o �, cipz 0 w - i ,•I� flp y��,v\ ELEC. METER ---' O IrIZ�I� o ��I I% �� W I%I• L) M = EXISTING 2 STORY HOUSE O �I,,,► C� 44 • C PO NEW ASPHALT DRIVEWAY i� I %A._ � CA J WI%I�IY ' ' S� �PG� .IS % WI AN._ % V �#% wI�I� � A 44, -we lib hbAir T \ .AI�I• � \ .�I�I�I%I�I �� V41 (J) ♦ 0 v % ISI \ \— r NEW RAISED PATIO OD \. \� I-1 (i) c� co \ \ / ill O' O vv/PERGOLA ABOVE \ j`4•, ,I,' w >r � �� o .� L � 0 co 2\ \ — — • . 10'-0" \ I I 0 U ro a ms I :lair � � Z.. co \ \\ ---- Eh. mamma III \ , �, I 1 1 I ►, 1 III�Dp''�VgIII \ PROPOSED CONSTRUCTION L , w ,I i IIIIII IIIIII \ \\ EXISTING SLATE ■ I [� �I VIII VI11111 \ I� IIII PATIO AREA \ WA,%Ahh...I�\ IIS SII\\ \ J ,I, 1 NORTH \ \ I ,IO i EXISTING OVERHEAD —..— ' E. 4*/ 1 - °I1IIIIIIIIIIIIIIIIIIIIIIIIII111111' ;I \,, UTILITIES - — — -- — \\ \\ 1 I ❑ a*% V\ -.. C� zI %� I% N I %I�I i i - N \ ♦ , D I , --_. C o Z \\\ L ROOF LINE (TYP.) J O I M O \ • \ %I�' Jw � I U ¢ w \ \ I�� \\ ♦ \\ �°i �I�I \ ,ISI ZONING INFORMATION \ \\ i ��, I.,I;I I ` .\ \ ♦ \ ZONE:UR-3 \. \ I I y DEED NO. 202 1020526 ,I% LOT AREA: 7,691 sq.ft. \ v o3 i \ • y \\ AREA=7,69 1 5Q.FT , I i I,I� EXISTING ALLOWED PROPOSED \ \— \ TAX MAP PARCEL NO. 166.53- 1 -36 Q\� ---' I./ ,I�I '' I�I�I PRINCIPAL LOT COVERAGE: 1,425 sq.ft. (18.5%) 3,200 sq.ft. (20%) 2,863 sq.ft. (37.2%) \\ \\V ----' i ; �I� ACCESSORY LOT COVERAGE: 0 sq.ft. (0%) 769 sq.ft. (10%) 0 sq.ft. (0%) \ ♦ — / �►I � I1I� SINGLE SIDE SETBACK: 421-6-3/4" 4'-0"min. 4'-0" \ \ -- / TOTAL SIDE SETBACK: 861-3-3/4" 12'-0"min. 341-11-3/8" L9 A --' : FRONT SETBACK: 0" (P.N.) 10'-0"min. 0" (P.N.) \V ♦ A\ -- • — • REAR SETBACK: N/A(Corner Lot) 25'-0" min. N/A(Corner Lot) \ --- . MINIMUM FIRST FLOOR AREA: 1,103 sq.ft. 800 sq.ft. 2,173 sq.ft. \ \ -- —' • / J MAX HEIGHT: 27'-5" 60 0 271-2" \. ♦ \� -- / Iu ,<c v --i • • �/ \ \ � / U i I MIN TO REMAIN PERMEABLE: 4,623 sq.ft. (60.1%) 1,923 sq.ft. 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Complete all items in Part 1.You may also provide any additional information which you believe will be needed by or useful to the lead agency;attach additional pages as necessary to supplement any item. Part 1—Project and Sponsor Information Frost Hurff Architects,PLLC. Name of Action or Project: Beck Residence Renovation/Addition Project Location(describe,and attach a location map): 235 Nelson Ave Saratoga Springs,NY 12866 Brief Description of Proposed Action: An addition consisting of garage space,sunroom,office and master suite shall be constructed on the rear of the existing residence. Name of Applicant or Sponsor: Telephone: Rachel&Dyllan Beck E-Mail: racheleisenhauer@gmail.com Address: 235 Nelson Ave City/PO: State: Zip Code: Saratoga Springs NY 12866 1. Does the proposed action only involve the legislative adoption of a plan, local law,ordinance, NO YES administrative rule,or regulation? If Yes,attach a narrative description of the intent of the proposed action and the environmental resources that111 ❑ may be affected in the municipality and proceed to Part 2. If no,continue to question 2. 2. Does the proposed action require a permit,approval or funding from any other government Agency? NO YES If Yes,list agency(s)name and permit or approval:City of Saratoga Springs Building Department IT! Permit 3. a.Total acreage of the site of the proposed action? 0.18 acres b.Total acreage to be physically disturbed? .04 acres c.Total acreage(project site and any contiguous properties)owned or controlled by the applicant or project sponsor? 0.18 acres 4. Check all land uses that occur on,are adjoining or near the proposed action: ❑Urban ❑ Rural(non-agriculture) 0 Industrial ❑ Commercial m Residential(suburban) 0 Forest ❑ Agriculture ❑ Aquatic ❑ Other(Specify): ❑Parkland Page 1 of 3 SEAF 2019 5. Is the proposed action, NO YES N/A a. A permitted use under the zoning regulations? ❑ ✓❑ ❑ b. Consistent with the adopted comprehensive plan? ❑ E ❑ NO YES 6. Is the proposed action consistent with the predominant character of the existing built or natural landscape? ❑ ❑✓ 7. Is the site of the proposed action located in,or does it adjoin,a state listed Critical Environmental Area? NO YES If Yes, identify: ✓ ❑ NO YES 8. a. Will the proposed action result in a substantial increase in traffic above present levels? ❑ CI b. Are public transportation services available at or near the site of the proposed action? El ii c. Are any pedestrian accommodations or bicycle routes available on or near the site of the proposed ❑ action? 9. Does the proposed action meet or exceed the state energy code requirements? NO YES If the proposed action will exceed requirements,describe design features and technologies: Proposed work will meet state energy code requirements. ❑ 10. Will the proposed action connect to an existing public/private water supply? NO YES If No,describe method for providing potable water: nn 11. Will the proposed action connect to existing wastewater utilities? NO YES If No,describe method for providing wastewater treatment: E .❑✓ 12. a.Does the project site contain,or is it substantially contiguous to,a building,archaeological site,or district NO YES which is listed on the National or State Register of Historic Places,or that has been determined by the El of the NYS Office of Parks,Recreation and Historic Preservation to be eligible for listing on the State Register of Historic Places? b.Is the project site,or any portion of it,located in or adjacent to an area designated as sensitive for CI ❑ archaeological sites on the NY State Historic Preservation Office(SIIPO)archaeological site inventory? 13. a. Does any portion of the site of the proposed action,or lands adjoining the proposed action,contain NO YES wetlands or other waterbodies regulated by a federal,state or local agency? El — b. Would the proposed action physically alter,or encroach into,any existing wetland or waterbody? ❑ If Yes,identify the wetland or waterbody and extent of alterations in square feet or acres: Page 2 of 3 14. Identify the typical habitat types that occur on,or are likely to be found on the project site.Check all that apply: 0 Shoreline ❑ Forest ❑Agricultural/grasslands ❑ Early mid-successional D Wetland ❑ Urban m Suburban 15. Does the site of the proposed action contain any species of animal,or associated habitats, listed by the State or NO YES Federal government as threatened or endangered? ❑ ❑ 16. Is the project site located in the 100-year flood plan? NO YES ❑✓ ❑ 17. Will the proposed action create storm water discharge,either from point or non-point sources? NO YES If Yes, ❑✓ ❑ a. Will storm water discharges flow to adjacent properties? ❑ ❑ b. Will storm water discharges be directed to established conveyance systems(runoff and storm drains)? ❑ ❑ if Yes,briefly describe: 18. Does the proposed action include construction or other activities that would result in the impoundment of water NO YES or other liquids(e.g.,retention pond,waste lagoon,dam)? If Yes,explain the purpose and size of the impoundment: E 19. Has the site of the proposed action or an adjoining property been the location of an active or closed solid waste NO YES management facility? If Yes,describe: ❑ 20.Has the site of the proposed action or an adjoining property been the subject of remediation(ongoing or NO YES completed) for hazardous waste? If Yes, describe: ri I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE Applicant/sponsor/name: Frost Hurff Architects,PLLC. Date:10/12/2021 1 Signature: .�ti Title:Principal PRINT FORM Page 3 of 3