HomeMy WebLinkAbout20220011 143 W. Circular Subdivision DPW Water Agreement ���"��OC`' �s'�-, City of Saratoga S�rings
�� ��� � ��!� DepartmeYct of Public Works
_ ��,�� �� I5"IlaYcderbiltAvera��e (tem�orary address� Anthony J. Scirocco
- � '�;�� ��� Saratoga SpriYtgs, N'Y� 12866 Commissioner
�"`��P�oq��� ��� �518� 5'87-35'S'0 o�f'ice Joseph J. O'Neill
www.saratoga-s�rings.org Deputy Commissioner
NEW WATER SERVICE CONNECTION
AGREEMENT & APPLICATION FORM
Subdivision of the Lands
Willard F. Chamberlin, Jr of Willard F Chamberlin, Jr
Property Owner's Name Project Name (if applicable)
Property Address 143 West Circular Street (lot 2) Tax Map#: 165.74-1-37
Size of Tap (check one below)
X 3/4 " 1" Greater than 1"
A ttnit of water shall be defined as 14,000 (fottrteen
thottsand) cttbic 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 16,100
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
Company Phone Number Fax Number Date
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Department of Pttblic Works Approval Date: