Text · page 19 of 64
Read the whole document on one page (all 64 pages, each with its own heading)
This document was a scan. Its text was produced by character recognition and may contain errors; check the original for exact wording.
Proposed water service: Ca'+4-_ public private (well) n/a Is this existing Y/N Proposed sanitary sewer: public private (septic) n/a Is this existing Y)N Hours of operation (if applicable): Day Monday | Tuesday | Wednesday | Thursday | Friday | Saturday | Sunday By Appt. a Hours | 7 vy Va Peak hours: Number of employees (if applicable): Full-time _4/ Part-time Seasonal Upon approval of this application, the applicant intends to apply for: (Check all that apply) a. Building Permit b. Sign Permit IV. SIGNATURE (This application must be signed by the applicant/petitioner. If the applicant is not the owner of the property, a separate owner authorization form must be submitted — see pg. 4) SoA YO Yeo ~~~ Signature of Applicant/Petitioner Reber? Metl bo pms Print name of Applicant/Petitioner State of New York; County of Erie On the (5 Gay ot Lipiaty in the year 2@2Z@ before me, the above individual appearéd, personally known to me on the basis of satisfactory evidence to be the individual whose name is subscribed to the within instrument and acknowledged to me that he/she/they executed the same for the-furposes therein stated. litte, Ag SOP gram’ Sp” Notary Public (Notary stamp) Hi, tie County 3 Qi. orvionsndze Hes “Ua SSI0N exo Mea Office Use Only: Date received: Receipt #: Application reviewed by: