HomeMy WebLinkAbout20250601 24 Fifth Ave Special Use Permit 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 Modification
APPLICANT(S)*
Temporary
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.
Has a previous application been filed with PB for this property? NO ____ YES ____
If YES, include Application TYPE _______________________ and DATE: _______________
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.
Revised 8/2022
CITY OF SARATOGA SPRINGS
PLANNING BOARD
CITY HALL - 474 BROADWAY
SARATOGA SPRINGS, NEW YORK 12866-2296
TEL: 518-587-3550 X2533
www.saratoga-springs.org
[FOR OFFICE USE]
_______________
(Application #)
____________
(Date received)
__________________________
(Project Title)
Check if PH Required
Staff Review _______________
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