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20180432 18.031 153SouthBWay_WATER SERVICE FORMCity of Saratoga Springs OFFICE OF PUBLIC WORKS 5 Lake Avenue Saratoga Springs, New York 12866 Phone 518-587-3550 ** Fax 518-587-2417 www.saratoga-springs.org NEW WATER SERVICE CONNECTION AGREEMENT & APPLICATION FORM KCG Development Property Owner's Name: 153 South Broadway Property Address: Size of Tap (check one below): 3/4 1" 110 Number of Dwellings: A -110NY J. SCIRCccO COMMISSIONER. TIMOTHY 3• COGAN DEPUTY COMMISSIONER Project Name (if applicable) 153 S. Broadway Tax Map#: 178.27-1-22 thru 29 Treater than 1" unit of water shall be defined as fourteen thousand (14,000) cubic feet of water per year. Contact the Water Dept at ext. 2502 for assistance with water use estimation and meter specifications before signing below. Estimated Cubic Feet of Water per Year: 1,489,174 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 th Authorized Signa Company Address: ocument will be delivered to all appropriate and necessary governmental entities. Company Name: KCG Development 55"N_ Meri• = . St. Suiw , Carmel, IN 46032 Phone Number: 850-559-8606 Fax Number: Date: Department of Public Works Approval: Date: