Subdivision Modification Application Final Stage November 2021
General Information
Tax Parcel ID Number: 2�p-q- �(p.►Z
Zoning District:
Application Stage [check onel:
Sketch Plan Stage
Preliminary Stage
Final Stage
Indicate the following:
Number of lots proposed
Residential or Commercial 12u-�V%J c.r !-i✓%At-
Total Lot acreage � ;'Zg sac. 4
Proposed lot sizes
Project location rFk!tyEMS--'?;�,� [ =oFF CA-C V WI2.D—A .
Detailed Description of Project [include current&proposed use]:
Applicant Name: Address: 1-77 c_-"A rF_L_ tJvu T_'j
1A
Home Phone Cell:
5 'Z3`j- 11
Work Phone Fax
E-Mail:
Agent's Name: Ntr1 t c"7 G> .1� "`� Address:
Home Phone Cell
Work Phone 5 ig -:!)776:P„+Atg5 Fax
E-mail � Cbapl1p cc,,rn
Owner's Name "Z,a.VrA=*4*D V'r-^r-T Address
L.EiT 2 ZAfr 9 LE N I ze Zc;)
Home Phone Cell
Work Phone Fax
E-mail
Town of Queensbury Planning Office- 742 Bay Road-Queensbury, NY 12804.518-761-8220 1