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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 2