HomeMy WebLinkAboutDevelopment Review Application, September 22, 2017Development Review Application
Building Permit Number:
Project Title: /110N.e!0-
Project Address: CL-4,6-
v�er
Tax Parcel ID: 2 -
Type
Type of Application: (Minor Subdivision
Type of Development:S • _� _ _ j ;� J
Stage of Review: Sketch Preliminary _� Final -%Z_ Additional meeting
Estimated site improvement / project cost:
(Exclude cost of land acquisition & professional fees)
Total number of lots proposed (existing + new):
Are new roads or public utilities proposed?
Applicant / Agent
Name: aid Imo , E . Ra, AA ey
Address: 1 q Pe--�c,r e-4
Phone:f�a,7 S47- 92z,7
Consultant
Name:
Address:
Title:
�•}�llseifvil�� gay is-AcCl
Email:
Title:
Phone: Email:
Owne / Lessee / Engineer / Attorney / Other (circle one)
am e: 5tn.W- qs ar.�ove Title:
Address:
Phone:
Email:
ALL APPLICATIONS:
The information on this application form is submitted in addition to other information, plats, and plans required by the
Town of Danby. I attest that all information so submitted is complete and accurate to the best of my knowledge. Also, by
filing this application, permission is granted to members of the various Town Boards, Committees, Planning and Code
Enforcement staff, and/or any other persons designated by the Town that may be involved in the review of this
application, ig ester the property specified above to inspect in connection with the review of this application.
`r-�i Z-17
Q�vner's signature date Applicant/Agent signature date
2