HomeMy WebLinkAbout20240588 NYS Route 9 Preliminary Subdivision Water Service Agreement City of Saratoga Springs
UTILITIES DEPARTMENT
Department of Public Works
474 Broadway-RM 12
Saratoga Springs, New York 12866
_____________________
Telephone 518-587-3550
Email: utilities@saratoga-springs.org
www.saratoga-springs.org
UPDATED 6/8/23
JASON GOLUB
COMMISSIONER
JOSEPH O’NEILL, III
DEPUTY COMMISSIONER
MICHAEL VEITCH
BUSINESS MANAGER
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 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 ________________ EMAIL _________________________________ Date __________
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OFFICE USE ONLY:
Department of Public Works Approval ______________________________ Date: ______________________