HomeMy WebLinkAboutDevelopment Review Application, May 6, 2018Development Review Application
Building Permit Number: __________ _
Project Title: second dwelling
Project Address: _5_2_0_W_K_in_,,g::,__R_d ______ _
Tax Parcel ID: 1.-1-3 .35 ---------------
Type of Application : Special Use Permit
Type of Development' .d t · 1 · res, en ,a
Stage of Review: Sketc _ re ImInary __ Final __ Additional meeting __
Est imated site improvement / project cost: $ J. D 1 ()a)' ~
(Exclude cost of land acquisition & professional fees)
Total number of lots proposed (existing + new): ___ _
Are new roads or public utilities proposed? EJ
Applicant / Agent
· Name : ~(•\d\ G~ ;~:::~=r:t~:;-~11 iU
~'.\L Title:_,~..........,-------~~-~---
Consultant
Name:~ ttboV:& Title: ________ _
Address: ______________________ _
Phone: _____________ Email: ________ _
,,.-----0~ Lessee/ Engine~r /Attorney/ Other (circle one)
Name: · ,r, Title : ________ _
Address: ~lhA, t ' Y t \..\, S 0
Phone: .......,:.=......,__.....__,_=--..,.:'41'i'i:....&----Email: SY-!2M1f«r; m,tza.~; J •to M
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 variou s Town Boards , Committe es, Planning and Code
Enforcement staff, and/or any other persons designated by the Town that may be involved in th e review of this
application, to enter the property specified above to inspect in connection with the review of th is applicati n.
15r]I\ .c=: ~f(J/2g ~~~ t
owner's signature date' Applicant/Agent signature te
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