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Town of Aurora Town Board
575 Oakwood Avenue, East Aurora NY, 14052
| Special Use Permit Application Form
I. PROJECT INFORMATION (Applicant/Petitioner):
Business/Project Name: __Tne. e room lla fost
Business/Project Address: SG 4 BotMio 24 a Q..
Applicant Name: Rebeata Bee mungnam
Mailing Address: 5SF BosttwWo .
city Ease Runa _ State Ny ZIP UTS
Phone LIla-GS
2 PORY Fax we Email bee ky her )
interest in the property (ex: owner/purchaser/developer)
i. PROPERTY OWNER INFORMATION ((f different than Applicant AND the Owner does not sign below, please
submit and original, notarized “Owner Authorization” form ~ attached):
Property Owner(s) Name(s) aKue Sepplu Cok rss, ine “
If a corporate, please name a responsible party/designated officer: Nite hack Samudsbe a
Address Fog ANT ADS, Foals, Ri he
city Now “Rncduenda ” State zip__ 141a@
Phone “Ho G9a-lb00 _ Fax Emall “Hike Rams © To cy. oen
lil. SPECIAL USE AND PROPERTY INFORMATION:
Property Address 55% RK vELa\o Ra GOK
SBL# art. 00-\-I|lo
35 |
(rea)
i
Dy Chie:
. er ae
Property size in acres 3 mi: Ks Property Frontage in feet ad
Zoning District__ C-4 {2 *}
. Surrounding Zoning ¢/, “3, Rid f
Current Use of Property Keto. 4
-
Size of existing building(s): 500 sf Sizeof proposed building(s) SOO sf
' Present/Prior tenant/use: Slenunae
Parking spaces: Existing: ( Proposed additional spaces: DB Total #: (