HomeMy WebLinkAbout20260503 128 Circular St 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.
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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 1/2026
CITY OF SARATOGA SPRINGS
PLANNING BOARD
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[FOR OFFICE USE]
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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 $UWLFOH of the 8QLILHG'HYHORSPHQW2UGLQDQFH 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.
Owner Signature: ______________________________________________ Date __________________
REQUIRED ITEMS
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