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Proposed water service: _* public private (well) n/a Is this existing Y/N Yes
Proposed sanitary sewer: public _ *_ private (septic) ra Is this existing Y/N i but to
increased
Hours of operation (if applicable):
Day Monday | Tuesday | Wednesday | Thursday | Friday | Saturday | Sunday By Appt.
Hours | ALL ALL ALL ALL ALL ALL ALL WA
Peak hours: _N/A
Number of employees (if applicable): Full-time ° Part-time 2 Seasonal _°
Upon approval of this application, the applicant intends to apply for: (Check all that apply)
a. Building Permit _*
b. Sign Permit x
IV. SIGNATURE (This application must be signed by the applicant/petitioner. If the applicant is not
the owner of the properly, a separate owner authorization form must be submitted — see pg. 4)
(SBE.BP
“Signature of Applicdnt/Petitioner
Carner Development Group Inc., by Rachel Krajewski, President
Print name of Applicant/Petitioner
State of New York; County of Erie
On the teh day ofretmay in the year 2026 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 the ho. stated.
Ab epor>
Notary Public |/ \
RYAN MCCARTHY
NOTARY PUBLIC, STATE OF NEW YORK
{Notary stamp) Registration No. 02MC6277628
Qualified in Erie County
Commission Expires March 11, 2029
Office Use Only: Daie received: Receipt #:
Application reviewed by: