TOWN OF WEBSTER
SUBDIVISION / SITE PLAN APPLICATION (4 lots or less)
Office (585) 872-7028 * Fax (585) 872-1352 ¢ planning-zoning@ci.webster.ny.us
Applicant/Contact Person: Name: Tyler Arnold Address: 638 Lake Rd. Webster, NY 14580
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Property Owner Information (if different than above):
Phone:
Cell Phone:
Engineer / Surveyor (if applicable): Name: Cox Engineering Address: 677 Gasberry Ln. Webster, NY 14580
537 Vosburg Rd. Webster, NY 14580
Sees Number of proposed lots: 1
Project Description (additional information can be attached):
Proposed construction of a single family house.
By the signature below, on behalf of the applicant or owner, | hereby authorize representatives from the Town of Webster to enter the above referenced property, during normal hours, for the purpose of conducting inspections of the proposed construction/activity, as required by applicable law, rules, regulations, ordinances and orders. | also certify that the information supplied on this application is complete and accurate, and that the project described, if approved, will be completed in accordance with the age ae gly of that approval.
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Office Use Onion A
NON-COLLUSION DISCLOSURE PURSUANT TO SECTION 350-104 OF THE WESTER ZONING ORDINANCE
TO WHOM IT MAY CONCERN:
No officer or employee of the State of New York, County of Monroe or Town of Webster has any
financial interest in the land affected by or in the partnership making application for the project known as 537 Vosburg
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BY:
Submission Checklist:
No. of copies:
e Completed Subdivision / Site Plan Application 5 e Site Plan / Subdivision plan (folded to 9" x 14 1/2" maximum size) 5 e Environmental Assessment Form (EAF) 1 e Non-collusion disclosure signed 1 e Owner's Affidavit (if owner is different than applicant) 1 e Fees paid: $ N/A
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In some cases, subdivision of lots may require a review referral to Monroe County Planning &
Development. For these projects, an additional (5) complete application sets will be required
at time of submittal.
Concept Plan (each application) $100.00 Environmental Assessment Form (EAF) $50.00 Preliminary / Final Administrative Review $200.00
*All checks shall be made payable to Webster Town Clerk*