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HomeMy WebLinkAbout20221061 West Ave & Station Lane Sketch Site Plan SUP Applicationp. 1 of 2 Property Address/Location:_______________________________________________________________________ Tax Parcel #: _______________________________ Zoning District:_______________________________ (for example: 165.52-4-37) Proposed Use:_________________________________________________________________________________ Type of Special Use Permit:Permanent Temporary Renewable Modification APPLICANT(S)*OWNER(S) (If not applicant)ATTORNEY/AGENT Name Address Phone Email Identify primary contact person: †Applicant †Owner †Agent City of Saratoga Springs Application for Special Use Permit APPLICATION FOR: SPECIAL USE PERMIT HANDWRITTEN APPLICATIONS WILL NOT BE ACCEPTED!! * An applicant must be the property owner, lessee, or one with an option to lease or purchase the property in question. +DVDSUHYLRXVDSSOLFDWLRQEHHQILOHGZLWK3%IRUWKLVSURSHUW\"12BBBB<(6BBBB ,I<(6LQFOXGH$SSOLFDWLRQ7<3(BBBBBBBBBBBBBBBBBBBBBBBDQG'$7(BBBBBBBBBBBBBBB Please check the following to affirm information is included with submission. Sketch Plan Attached: Applicant is encouraged to submit sketch plans showing features of the site and /or neighborhood and illustrate proposed use. Environmental Assessment Form: All applications must include a completed SEQR Short or Long Form. SEQR Forms can be completed at http:// www.dec.ny.gov/permits/6191.html. Water Service Connection Agreement- For all projects including new water connections to the City system, a copy of a signed water service connection fee agreement with the City Department of Public Works is required and MUST be submitted with this application. ZĞǀŝƐĞĚϭͬϮϬϮϭ CITY OF SARATOGA SPRINGS 3/$11,1*%2$5' &,7<+$//%52$':$< 6$5$72*$635,1*61(:<25. 7(/; ZZZVDUDWRJDVSULQJVRUJ [FOR OFFICE USE] _____________BB $SSOLFDWLRQ  _________BB_ 'DWHUHFHLYHG  @@@@@@@@@@@@@@@@@@@@@@@@@@ 3URMHFW7LWOH &KHFNLI3+5HTXLUHG 6WDII5HYLHZBBBBBBBBBBBBBBB Corner of West Avenue & Station Lane 165.-2-76.2 T-5 Transect Zone 5 Retail, Eating & Drinking Establishment, Multi-family, Office 165 Lake Ave, Saratoga Springs, NY 12866 (518) 796-3716 russellfaden@yahoo.com West Station LLC Lansing Engineering 2452 State Route 9, Suite 301, Malta, NY 12020 (518) 899-5243 ysl@lansingengineering.com ■ X Sketch Plan & SUP 5/9/2017 City of Saratoga Springs p. 2 of 2 Application for Special Use Permit Does any City officer, employee or family member thereof have a financial interest (as defined by General Municipal Law Section 809) in this application? YES_____ NO _____. If YES, a statement disclosing the name, residence, nature and extent of this interest must be filed with this application. I, the undersigned owner, leasee or purchaser under contract for the property, hereby request Special Use Permit approval by the Planning Board for the identified property above. I agree to meet all requirements under Section 240-7.1 of the Zoning Code of the City of Saratoga Springs. Furthermore, I hereby authorize members of the Planning Board and designated City staff to enter the property associated with this application for purposes of conducting any necessary site inspections relating to this application. Applicant Signature: ______________________________________________ Date:__________________ If applicant is not current owner, owner must also sign. 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