HomeMy WebLinkAboutDevelopment Review Application, October 3, 2017Development Review Application
Building Permit Number: _________ _
Project Title: ______________ _
Project Address: _____________ _
Tax Parcel ID: 15.-1-11.3 ---------------
Type of Application: Minor Subdivision
Type of Development: residential
Stage of Review: Sketc -X-re rmmary __)(_ Final ~ Additional meeting __
Estimated site improvement/ project cost: $200,000
(Exclude cost of land acquisition & professional fees)
Total number of lots proposed (existing + new): ..... 2 __ _
Are new roads or public utilities proposed? ~
Applicant / Agent
Name: Cindy Black/ Andrea Butje Title: _O_w_n_e_r_s ____ _
Address: 1040 Comfort Rd ., Spencer, NY 14883
Phone: (941) 323-3493 Email : cindyblack63@gmail.com
Consultant
Name: _____________ Title : ________ _
Address : ______________________ _
Phone: _____________ Email: ________ _
Owner I Lessee / Engineer / Attorney / Other (circle one)
Name: _____________ Title: ________ _
Address: ______________________ _
Phone: ____________ Email: ________ _
ALL APPLICATIONS:
The information on this applicat ion 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
fi ling this application , permission is granted to members of the various Town Boar d s, Committees, Planning and Cod e
Enforcement staff, and/or any other persons designated by the Town that may be involved in the review of this
application , to nter the property specified above to inspect in connection with the review ~Uhis applif?ation.
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date
1V/7
Applicant/Agent signature date
2