HomeMy WebLinkAbout20220235 131 Excelsior North Spring Run Special Use Permit Water Service Connection Agreement �`pG� S� • Ar��lorrYJ.Scmocco
� .� ,� C�ty of Saratoga Springs �o�S�zQ�R
�, � rd� OFFYCE OF PUBLIC WORKS �oTxY J.CoG�rr
p - � r-� 5 Lake Avenue DEPCJTY COriIMTSS10NER
� � - :� Saratoga 5prings,New York 12866 _
� fl..�` .. �. t
� `��:G'�� Phoz�e 518-587-3550**Fax 5X8-587-241.7 �
/��ORpoRA��o '`�1y r�vww.saratoga-springs.org -
� �
NEW WATER SERV�CE CONNECTION
AGREEMENT &APPLZCATION FORM
� Saratoga Dairy, Inc. North Spring Run -
Property Owner's Name: Projeet Name{if applicable):
131 Excelsior Avenue 166.30-1-3
Property Address: Tax Map#:
Size of Tap (check on.e belaw}:
�3/a» �» �reater than 1"
'�un�t af vvater shall be defined as fourteen thousa�nd(14,000} cubic feet
of water per year.
Cantact the Water Dept at ext. 2502 for assistance with water
use estimation and m�ter specifications befora signing beiow.
Number o�Dwellings: Est�mated Cubic Feet of Water per Year:
To be co�npleted in. full without az�y contingencies or protest, on or i�efore the Building Inspector approval of the rongh piumbing,
including the installation of the water rneter,or at�e time of the issuance of a#apping pern�.it.
The undersigned represents to the City that tlxey have full and complete authority to ex�cute th�is document and fmd and commit the
developer to abide by the City Water Ordinance. This agreez�nent sha�l be binding on all of the undersigned nansferees.
The undersigned acknowiedges that a copy of�is document will be delivered to all appropriate and necessary go�ernmental entities. _
k
l�-'� �� Conifer Realty, LLC �
Authorized Signature: '� ` Company Name: _
100 Univer��Ave, Rochester, NY 14607
Company Addr�ss: �
Phone Number: (585) 324-0542 Fax N�.unber: Date:
......................�-----........................ -.....----..................................................................................................................................................................................................
Department o�Public Warks Approval: Date: -
�