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Building Dept: Date Received _ _ __ VILLAGE OF EAST AURORA I n conjunction ,vit.b the Town of A\lrora Buildi,ng Department Complete App _ _ __ 585 Onkwood Aven ue, East Aurora, 575 Oakwood Avenue, Ea$t Aurora, Village Clerk: New Yor k 14052 716-652-@00 opt 4 New York 14052 716-652-1591 Date Received _ _ __ Amount$_ _ _ __ SITE PLAN APPLICATION Receipt# _ _ _ __ PROPOSED PROJECT Verizon's East Aurora Cluster SBL#: NIA ----------- LOCATION in front of 30 Buffalo Road ZONING DISTRICT NC/MMO The applicant agrees to reimburse the Village for any additional fees required for the consultant's review of submitted technical data, including but not limited to traffic studies, drainage, lighting, water, and sewer plans. APPLJCANT NAME Bell Atlantic Mobile Systems LLC d/b/a Verizon ADDRESS 175 • • • r, NY 14623 TELEPHONE ( sq.} E-MAILilusk@nixonpeabody,com SIGNATURE---'l~f-t,......._.,c....-=---=,.L---------------- OWNER NAME --+-i-----:"'----- - - - - - - - - - - - - - - - - - - - - - - -- - ADDRESS 3 City enter, 180 South Clinton Ave., Rochester, NY, 14604 TELEPHONE _ _ _ _ _ _ _ _ _ _ _ _ _ _ _.E-MAIL_ _ _ _ _ _ _ _ _ _ _ _ __ S1GNATURE See Exhibit E ENGINEER/ARCHITECT/LANDSCAPE ARCHITECT NAME Martin Willix FIR.i\ll Erdman Anthony ADDRESS 145 Culver Road, Suite 200, Rochester, NY 14620 TELEPHONE (585} 427-8888 E-MAIL - - - - - - - - - -- - - - - SIGNATURE See Exhibit 0 AFFIX STAMP THIS APPLICATTON MUST TNCLUDE THE FOLLOWING: • Twenty (20) Sets - Cover letter to Village Board, Supporting Documents, and SEQR as required in §285-51.3 • One (1) complete file of submittal package in PDF format via email (under I 0MB). Larger files may be submitted on a USB drive. • Application fee $25.00 and Public Hearing fee $100.00 - Total $125 at time of application OFFICE USE ONLY: Sketch Plan Meeting Date _ _ _ _ Minor Project wriuen request to waive PC nug YIN/NA: VB Decision YIN REQUIRED MEETINGS/REFERRALS: Mtg/Mail Date Conditions/Comments, ifapplicable: Planning Commission Historic Preservation ZBA EC Div of Planning NYSDOT Town Notification Safety Committee VEADPW OTHER (specify) SEQRACTION: _Type I _ _ Type 2 _Unlisted VILLAGE BOARD ACTION: Mtg/Mail Date Public Hearing Notices Mailed Posted Notice-VEA Hall Posted Notice-Prop Approval/Denial Date Attach Village Board resolution with noted conditions. Page 2 of3