Final Stage Subdivision Application 1 uwN Uh QUh NSBUKY
SUBDIVISION APPLICATIO=BE
APPLICATION
Date Submitted to Department
OF I N A L S T A G E •
To Be Reviewed By: Queensbury Planning Board
Town of Queensbury
Warren County, New York
Type I or Class A: _
Type II or Class B:
Adirondack Park Agency Referral:
Warren County Planning Board Referral:
NAME or TITLE OF SUBDIVISION: 41WR/ 04RDI IALc
Property Location: 706 o.c- 6a�i.✓r�QG:e��� .POAO
TAX MAP NUMBER: Section //f Block 6 Lot 3¢
ZONE CLASSIFICATION:
DATE OF PRELIMINARY APPROVAL: 3 -23-jP&
Preliminary review did ( ) did not determine that the project may have
an adverse environmental impact.
1. Applicant/Subdivider Name: Eowveo ,C/aey C9t�ocdAL�T
Street Address: /G ocp co�p� po g0
City, State, Zip: QvcBt%sa a e A/y /2�?oq/
Telephone No. (5161 79F1- 0,*W
2. Agent: Co�/�GG`�2 tyJ��o ztiAe
Street Address: J2 yyy ,37,Fce'7-
City, State, Zip: 4 zz—NS FAGzSS �//✓ /Zb'oI
Telephone No. (S/P)
3. Owner's Name: Eo-0-44 ,o vo �r19ey G:g2o�s✓AL E
Street Address:
City, State, Zip: Q L,1 e0A1.S 13 u Zy n/y
Telephone No. (_5,41 75c'd°- 61Y1
1
§. Surveyor: �o✓cTc� �/� Got /9C�<
License No. i✓yJ sic 3i 739-
Street Address: 9/2
City, State, Zip: L�iL�J FALLS, i(/x 12sol
telephone No. (Sid') 79Z- -7/y5-"
5. Engineer:
License No.
Street Address:
City, State, Zip:
Telephone No. ( )
6. Has the Preliminary Plan been altered in any manner either by Planning Board recommendation
or for any other reason?
YES ( ) NO (A )
If YES, attach a complete explanation thereof.
7. Required approvals determined by Preliminary Review:
YES NO
Federal ( ) (X)
State Dept. of Health ( ) ( ( )
State Dept. of Environmental Conservation ( ) ( )
State Dept. of Transportation ( ) (x )
Warren County Dept. of Public Works ( ) (X )
Town Highway Dept.
Town Water Dept.
8. Please complete and sign the "Authorization to Act as Agent For" form.
THE UNDERSIGNED HEREBY REQUESTS THE APPROVAL BY THE PLANNING
BOARD OF THE ABOVE IDENTIFIED FINAL PLAN
Signature and Title of the Applicant
2
b. The approval by the Planning Board of a Subdivision Plat shall not
be deemed to constitute or imply the acceptance by the Town of any
street, park, playground, or other open space shown on said Plat.
The Planning Board may require said Plat to be endorsed with
appropriate notes to this effect. If the Town Board determines
that a suitable park or parks of adequate size cannot be properly
located In any such Plat or Ss otherwise not practical, the Board
may require as a condition to approval of any much Plat a payment
to the Town of a sum to be determined by the Town, which sum shall
constitute a trust fund to be used by the Town Board exclusively
for neighborhood park, playground, or recreation purposes including
the acquisition of property. The planning Board may require the
filing of a written agreement between the applicant and the Town
Board covering future title, dedication, and provision for the cost
of grading, development, equipment, and maintenance of any park or
playground area.
Applicant and/or Agent please sign after reading all of the Final Plan Requirements
Applicant
/%
�`/�/cum / •�C ��s[ar¢.�,
Agent
TOWN OF QUEENSBURY
AUTHORIZATION
'TO ACT AS AGENT FOR•
I EptrA'.-O CARDIrJA 4.F p e a
seller/owner of remises located t
............... ........ K.......... ........................................
Tax Map Number ) )9 -e. - 34 hereby designate ..AiN4bQ-Ew T. M:c; tHAc1�
"D�T .................... . .. ............
iS�4 �'cuc.reTC �Hc�oG MAGIC
as my agent regarding an application for:
Suc3 ol� �S�aN........................................................................
(Subdivision) (Site Plan Review) (Variance)
r
of the above premises.
Deed Reference Book . 5�... Page 31 ... Date 4...s„1c9 Z
Does the above parcel represent owner's entire contiguous holdings? Please attach explanation.
Signed .`x . a-Ct
Date ... C.'� �..l.G..l. ......
i
TOWN OF QUEENSBURY
'The parties hereto consent that the proceedings which result from the within
application may be taped recorded and transcribed by the Town Clerk or his agent and
that such minutes as may he transcribed shall constitute the official record of all
proceedings regarding this application, unless the same may vary from the handwritten
minutes taken by the Town Clerk or the Secretary of the Planning Board or Zoning Board
of Appeals, in which event the handwritten minutes as to such inconsistencies shall be
deemed the official record.'
DATE: 1`{ A 12 • '30 19 q 3
(Applicant's Signature)
FOR OFFICE USE ONLY:
Application Number:
Applicants Name:
;i
SETTLED 1763 . . . HOME OF NATURAL BEAUTY . . . A GOOD PLACE TO LIVE