Application - Final Stage•
TOWN OF QUEENSBURY
SUBDIVISION APPLICATION - FINAL STAGE
Application No.:
1. Name/Title of Subdivision:
2. Owner -
Name:
Address.
3. Subdivider -
Name : �SM a Ka �oo
Address::2S�sfrf.
Sarato a
Phone /: (5 8) 587
4. Agent - Peter Loyola
Name: Continental ]
Address: 26 CmPuter ]
5. Surveyor/Engineer -
Name: Chester Gramin
Address: 157 Lake A
Inc.
N/A
LIC
6. Description of any item to be shown on the final plat as a
result of the Planning Board or Town engineer's review of the
preliminary plat:
T. Fees
The fee for submission of a final stage application is $50.00
plus $5.00 per lot of the proposed subdivision.
As a result of engineering concerns raised during the review
of the preliminary application for final application may be
referred to the Town Consulting Engineer for further review.
The hourly rate charge for the engineer review will be charged
directly to the applicant. Fees for engineering review will
not exceed $1,000:00 without notification to the applicant.
After approval of the final plat and before signature of the
plat by the Planning Board Chairman the applicant may be
required to pay a fee of $500.00 per lot in lieu of land
dedicated for use as recreation or park lands. (See S A183-18
of the Subdivision Regulations & Chapter 124 of the Town Code)
•
s.
9.
Signature of Owner
To the best of my knowledge the information in this
application and on the attached final plan is true and
accurate.
1, the undersigned, have thoroughly read and understand the
instructions for final submission, the final plan application
and the list of items to be shown on the final plan and I
consent to all the requirements as set forth in this
application.
Furthermore, I hereto consent that the proceedings which
result from the above application may be tape recorded and
transcribed by the Town clerk or his/her agent and that such
minutes as may be transcribed shall be 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, is which event the
handwritten minutes as to such inconsistencies shall be deemed
the official record.
Owner's Siga ture Date
Authorization to Act as Agent For:
In the event that the owner of the property desires to have
another individual act as his/her authorized representative in
support of this application the following statement must be
completed and signed:
owner of the premises
located at with the tax map no.
hereby designate
as my agent regarding an application for subdivision of the
premises.
Do not complete this response if completed with the sketch
plan or preliminary application.