Wetland Permit AppUpdated: 03/05/2004
TOWN OF QUEENSBURY
FRESHWATER WETLANDS PERMIT APPLICATION
APPLICATION NO.:
APPLICATION DATE:
This is an Application for a Permit to conduct/cause to conduct a regulated activity on or
adjacent to a freshwater wetland pursuant to Freshwater Wetlands Protection Law - Local
Law 1, 1976.
TO: Town Clerk of the Town of Queensbury - Please immediately forward this
application to the Planning Board of the Town of Queensbury by way of service upon the
Planning Department of the Town of Queensbury.
TO: Applicant - Please type or print the information required and complete all blanks and
answer all questions. If the information requested is not applicable, please enter N/A. Please
rovide the orig inal )lus 14 copies ofthis a ]iication with a 100 a ]ication fee.
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INFORMATION FOR APPLICATION
Applicant:
Name: Faden Enterprises
Address: 165 Lake Ave
Phone: . 518-796-3716
t 1N .r
Property lnfwj.. tion:
..4.
1. Narn`e ofv� gtland or any body of water/stream involved: '
unnamed Operennial stream }.
2. Address of parcel upon which wetland is located and address of parcel(s) upon which
work is proposed.
1471 Route 9
Lake Georcie, NY 12845
3.
4.
5.
6.
7.
Updated: 03/05/2004
Tax Map No. of parcel upon wetland is located and Tax Map No. of parcel upon
which work is proposed: 288,-1-58
Current zoning of parcel upon which wetland is located and current zoning of parcel
upon which work is proposed: Cl
Total area of property upon which work is proposed: 1.87± acres
Total area of wetland: 176f Ln. Ft. of perennial stream impact proposed
Dimensions of wetland: n/a
8. Existing uses of wetlands,
n/a
0J
Adjacent uses within 400 ft. of wetlands, if any: Commercial
10. State, County, Town property within 500 ft. of wetland:
TMP# 288.-1-47
Information About the Project:
if any:
1. Detailed description of proposed activity: Construction of a drive thru restaurant, 2 self -storage
buildings, associated roadway, parking areas, stormwater management areas, and connection to public water
and sanitary utilities.
2. Purpose, character and extent of proposed activity upon or adjacent to wetland:
Construction of a drive thru restaurant, 2 self -storage buildings, associated roadway, parking areas, stonmwater
management areas, and connection to public water and sanitary utilities.
3. On a map to be submitted with this application, show the area of the freshwater
wetland or adjacenA area. directly affected with the location of the proposed artiviiy.:„ ;
shown to scale the&n as well.
4. Will the project reguire,aany other Federal, State or local permits'? wr
ACOE Nationwide Permit 39
5. Has work begun on the project? No
6. Approximate starting date of project? 12/1/2022
7. Approximate completion date of project? 9/1 /2024
Updated: 03/05/2004
About the adjacent property owners:
List the names of the owners of record of lands adjacent to the freshwater wetland or
adjacent area upon which the project is to be undertaken:
MT Associates, LLC
Basket Barn of L.G. Inc.
Name of claimants of water rights which you have noticed and which relate to any land
within or within 100 ft. of the boundary of the property on which the proposed regulated
activity will be located:
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The foregoing information will be reviewed by the agency, and the agency, may if it desires,
request any further information necessary to make a decision.
I hereby affirm under penalty of perjury that the information provided herein and all
attachments submitted herewith are true to the best of my knowledge and belief. n
PC A's
Signature:
I hereby authorize
in connection with this application on my behalf.
to act as my agent and represent me