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CYry OF LACKAWANMA DEPARTMENT OF DEVELOPMENT 714 Ridge Road ~ Room 309 Lackawanna, NY 14218 Tel: (718) 827-6421 Fax: (716) 827-1866 APPLICATION TO THE CITY OF LACKAWANNA PLANNING AND DEVELOPMENT BOARD Date: 4 4 Lb ; ’ Application No, Site Plan Review Piling Fee $10.00. X Less than 0.5 acres ; , $ 50.00 __..0.6 to 1,0 acres ‘ § 200.00 10 to 2.0 actes : $400.00 $400.00 % Special Use Permit $ 500.00 ___.__ Development Flan Review $ 50.00 Property Aditress:_2-3 Gy een Sf: _ SBL.No., YZ. 763-3} ne hee lin ‘Casiudkon of 4 Sigh. Io ire thhet | Yo iy tt: add bas 3 Jed roomd. [Mrector of Development