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Proposed water service: Ca++ _ public private (well) n/a Is this existing Y/N Proposed sanitary sewer: public private (septic) vv n/a Is this existing YIN Hours of operation (if applicable): Day Monday | Tuesday | Wednesday | Thursday | Friday | Saturday | Sunday | By Appt. Hours | ~ vy. wv i” Va Peak hours: | Number of employees (if applicable): Full-time 4f _ 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 mustbe 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 ) BIA Vuk Vo el Signature of Applicant/Petitioner Robert Neil bo p(s Print:name of Applicant/Petitioner State of New York; County of Erie On the /5' day atLipwag in the year 226 before me, the above individual appeared, 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 th poses therein stated. Qnty, oe NE, H. Vie, a SS" SATE Py, £ [OFNEWYORE”, % Notary Public F fNOTARYPUBLIC', Qialied i : @3 % : 5; ES = ErieCouny = OF Notary stam stamp) (Notary % %. crac ws Vato ert! < cI tu, SION EXP TTT las Office Use Only: . Date received: Receipt #: Application reviewed by: