HomeMy WebLinkAboutDevelopment Review Application, July 12, 20187/12/2016 001.jpg
Development Review Application
Building Permit Number :_________ _ __
ProjectTitle: 6ar+h. R/w±tzrvt.s (!j,y,{d ()Jlre-
Project Addres s: / ;J 3 0 _bM1 b 'j R<J
T ax Parcel ID: · Q .. -/ -8 .,,._,_{ ____ _
Type of Application : Special Permit
Type of Development: D C:tre,,
Stage of Review: Sketc re 1mmary __ Final __ Addrtional meeting __
Estimated site Improvement / project cost -'11------
{Exdude cost of land acquisition & professional fees)
Total number of lots proposed (existing + new): ___ _
Are new roads or public utilities proposed? I "1 O I
------·-····----
Applicant I Agent
Name: De!tm ,7trkltJ: Title: dwaer /Ectr+tt ... R~'ll,tt15)le5-see
Address: Jll!dYAay-ctPst Rd l+fia ct<.TNJ JL/tS1J
Phone: & 0 7 -a-,q -Cf<P8 I Email:-------
Consultant
Name: _____________ Title: ________ _
Address : _____________________ _
....µ.u.µ.L ~~ltJL/.I,.·~ ILessor
~2::f!:::.~~J.tw~~~~~-~-),:,_r!,.-1 .;,'/lct'<f
Phone:-1,.L.--L--+-...L!..-.....:.==---Email: yo,~'Sq,'{Y\ <L.{-\C1-...• c..o..-Y".
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 StJbmitted ls 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
appli ion to ent~rope~ specified a~ove to inspect in connection wi1h the rev1e this application.
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owner·s signature dat App licant/Agent signature
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