HomeMy WebLinkAbout20260672 624 N Broadway Site Plan Water Service Connection AgreementCITY OF SARATOGA SPRINGS COMMISSIONER
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UTILITIES DEPARTMENT JOSEPH O'NEILL, III
DEPRT7 COMMISSIONER
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Department of Public Works
474 Broadway-RM 12 MICHAEL VEITCH
Saratoga Springs, New York 12866 RVSLNESSM.4LNAGER
QP-OgAL¢0 Telephone 518-587-3560
Email: utilities@saratoga-springs.m•g
www.saratoga-spriiigs.org
NEW WATER SERVICE CONNECTION
AGREEMENT & APPLICATION FORM
Unitarian Congregation of
Property Owner's Name _Saratoga Springs
Size of Tap (check one below)
Number of Dwellings:
Project Name (if applicable) 624 North Broadway
Tax Map #: 165.44-1-22
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.
Estimated Cubic Feet of Water per Year 64,240
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 acknowled a copy of this document will be delivered to appropriate and necessary
governmental entities.
Authorized Signature Print Name Michael Crisafulli
Company Name & Address
Company Phone Numbel(5'
OFFICE USE ONLY.
Department of Public Works Approval Date:
UPDATED 6/8/23