HomeMy WebLinkAboutNB5 - Aquifer Permit Application - ReaganTOYVN OF CORTLANDVIL1LE
3577 TERRACE ROAD
CORTLAND, NEW YORK I3045-3552
AOUIFER PROTECTION DISTRICT SPF-CIAL PERM
APPLICANT Fee Paid
Name Phone
Address
PROPERTY OWNER
Name Phone
Address
If applicant is a Corporationlist name, address, phone and fax numbers of all corporate
officers and directors on reverse Side.
PROPERTY INFORMATION
Location of property
Tax Map No. of Parcel
PROPERTY ACQUIRED ON, OR PENDING DATE OF AQUISTION
IS PROPERTY IN FLOOD PLAIN? YES NO
AQUIFER PROTECTION AREA
ZONING DISTRICT _
Informatha to be provided as per Article and Section 178-47 of the T of Cortlandville
Toning Law.
DATE OF APPLICATION //Z
Zoning Officer
Supervisor
PERMIT GRANTED
PERMIT DENIED
Name
Title
Address
Phone
Fax
Nance
Title
Address
Phone
Fax
Name
Title
Address
Phone
Fax
Name
Title
Address
Phone
Fax
Name
Title
Address
Phone
Fax
Name
Title
Address
Phone
Fax
Name
Title
Address
Phone
Fax
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