HomeMy WebLinkAbout20230996 395 Broadway Site Plan Water Service Agreement
NEW WATER SERVICE CONNECTION
AGREEMENT & APPLICATION FORM
Property Owner’s Name ________________________ Project Name (if applicable)___________________
Property Address ______________________________ Tax Map #: ________________________________
Size of Tap (check one below)
_____ ¾ “ ______ 1” ______ 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: _________________ Estimated Cubic Feet of Water per Year __________
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 _________________
******************************************************************************************
Department of Public Works Approval ______________________________ Date: ______________________
City of Saratoga Springs
Department of Public Works
15 Vanderbilt Avenue (temporary address)
Saratoga Springs, NY 12866
(518) 587-3550 office
www.saratoga-springs.org
Anthony J. Scirocco
Commissioner
Joseph J. O’Neill
Deputy Commissioner
Lisa Moser
395 Broadway, Saratoga Springs, NY 12866
395 Broadway Sketch Plan
165.59-1-88
*Existing water service to be utilized
for proposed building renovation.
170,057
Yates Scott Lansing
Lansing Engineering, 2452 State Route 9, Suite 301, Malta, NY 12020
518-899-5243 10/02/2023