HomeMy WebLinkAbout20240551 453-457 Broadway Site Plan Water Service AgreementCity of Saratoga Springs
> a �1A
co Department of Public Works
z 15 Panderbilt Avenue (temporary address)
Saratoga Springs, NY 12866
no RATED \g (518) 587-3550 office
www. saratoga-springs. org
NEW WATER SERVICE CONNECTION
AGREEMENT & APPLICATION FORM
Property Owner's Name
Property Address L Q'��u �cr� ( SaV6L S®�
Size of Tap (check one below)
Anthony J. Scirocco
Commissioner
Joseph J. O'Neill
Deputy Commissioner
Project Name (if applicable)
Tax Map #:
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: � � � � ���� r� � S Estimated Cubic Feet of Water per Year � l
`i4��. ���S=L• I
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 Sig nature Print Name
Company Name &Address
Company Phone Number\ aoZS - U �� D Fax Number
Date �-1
Department of Public Works Approval Date: