HomeMy WebLinkAboutDevelopment Review Application, December 29, 2017•
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Development Review Application
Building Permit ~umber.
Project Title: :{ioo,-L Com m,j 51rt?_/
Project Address: & 1 My uJ @ .J:tb t'l!ftr Al'!
TaxParcellD: 2. -1-1. J ______ _
Type of Application : Special Permit
Type of Development:
Stage of Review : Sketc re ,mmary _ Final __ Additional meeting _
Estimated site improvement/ project cost: ¢crol)
(Exclude cost of land acquisition & professional fees)
Total number of lots proposed (existing+ new): __ L_
Are new roads or public utilitie~ proposed? ~
Applicant / Agent ~
Name: ''12212,~ JjoeJJt+b
Address :. /l'l f,:f ldst-o1::t Ct/2. _
Phone(b;J) Q 79-657 3
Consultant
Name: _____________ Title:-'---------
Address: _____________________ _
Phone: ____________ Email: ________ _
Owner I Lessee I Engineer/ Attorney/ Other (circle one)
Name: Srfa7L ntJe: ______ _
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 thafall 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
E re ment s and/or any other persons designated by the Town that may be Involved in the review of this
.,applic tion,Jt> e e the property specified above to Inspect in connection with the review of this application.
ApplicanVAgent signature date
2
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