790 Ridge Rd App Bloom Blend Pb 9126

TOWN OF WEBSTER

PLANNING BOARD APPLICATION Office (585) 872-7032 ¢ Fax (585) 872-1352 ¢ planning-zoning@ci.webster.ny.us

U

Prope Oo Lo Information (if different than above): Name: Le nn010 Phone: — ——

Architect / Engineer if sontcatn:

Phon E-mail Sc ;etC“<;C

Application Type (please circle): Subdivision Accessory Special Use Review of land Structure Permit

Project Status (please circle): Concept Preliminary CPreliminary/Final>

Project Description (additional information can be attached): PHOS Cte Vener OC Inkenk oda cned, —REGEIVEN]

JUL 3.0 2026

TOWN OF WEBSTER DEPT. OF COMMUNITY DEVEL GPM

Length of time to complete project: Sev ON \npus | (25S ron \ Cas)

_———— DATE: 7 29/2u

Office Use Only Parcel Number (SBL): Zoning District:

| |

abetatiatinienen

mrewenat Coe #

oe gt gre a J

FY CHS A eG

OETA LAT RS. MOD Sh ASE

PRS se eH a ee)

unit Ww . i ' . 4 a | eos ; ps hyd WAP ESE [ y i Ls : oo I a oo h - ™~ . —l<— 4, < ats" De = me: wy a — nd - “p, eae ~* STU MRAT) \ctetta =

fo ma SD LTT eR TS cy RE RESIS AR UA NARS TN a A C!S RIS Deh) Ms ‘ 272% Jae too Sliingotigage _ ; 221A wh cpereala : { a ; ; vig TI oe siiod (ees sade toe eRe BH) center whl san el go gqotd i » : ; an 6a oa : : — erg ‘ ENUM HO Toa es | stolacoitereye, Fey amen pet \ ty ntheiot ht } 7 4 “5 Jf a HEI trg ‘aces ; a _ | __ tase tase ¢ t ’ * - AS Says ey f s = : Mer iS Bete ' ryt abiege PLS eel) fears PERO eS LIE AME) epo uw ticestyp ony Heide siggA iii*- waite ertyuh yl yialt =| " st Nha isiale es wenn Mist : Moa S sims Bitese. Seats bull sh ieeasteoay fh) Seed see CURA O EH, terse heey) actives’) tnejars | Li \ isha PA ete : . I i | pat LEE te ‘ F owe, oon" - —— ! 4-1 * “rs : stieriee white Gy Yaa ten Shalt abat ; Bh OW Neksiie Miya ONY -"ULs elt (abel eee eel ot 7 es livitio git 445 CTWASLISGA 1 aint rad PL Sie dey y ' UP bee *) y FTE Whey r Ln "i Mahe : VETOr Gade hale Pit, eT ase ie oT Bo My, DARN peets Alga aongo aay hy varus TeMeeyycnehs “es eeetiel Getety fone gt ' i Te ee AMT PLY tre ES. PTW agp ut raises “iy | ' vtril yt ei nieinre ays ths bed bers 4 Ter ‘ { ft ' ' : H 7 ye 7 ST aAAiie | a —_—— — oe —_ “over oe -- _ , t ‘=- 4 = i 7 rs 1 | ; ee re : a |

Members of the Webster Town Board,

On behalf of Bloom & Blend, we are requesting approval to add decorative exterior lighting at our location 790 Ridge Rd, Webster NY 14580.

We are requesting approval to install approximately 36 linear feet of decorative exterior lighting along the northeast side of the building, adjacent to our customer entrance. Due to the building's jocation and orientation, many first-time customers have reported difficuity locating our business from Ridge Rd or have unintentionally driven past without realizing we are there. The proposed lighting is intended to improve the visibility and overall appearance of the building, making it easier for customers to identify our location while maintaining a professional aesthetic. The lighting will consist of stationary LED lights that are non-flashing and directed toward the building to minimize any impact on neighboring businesses or passing motorists. The lighting is decorative in nature and will not create a glare, distraction, or nuisance, but rather installed to enhance the property's appearance and improve customer wayfinding.

Our goal with the lighting is simply to enhance the customer experience and increase awareness of our business while maintaining the professional appearance of the property and respecting the surrounding businesses.

We appreciate your consideration of this request and are happy to provide any additional information or answer any questions you may have. Thank you for your time and consideration!

Sincerely, Alyssa Connors

tee ee eerie cicy

Settee bee ai Gs ai

This is an Al generated conceptual rendering provided to illustrate the proposed appearance of the exterior lighting.

trate evens tebede: WH ele doch

(rishxe sy tenses bbs OM RVOK GE gritesupos JiF ty ONSET 8 Toul ia Meta: OaGar YM weladaw bai apis! O@T monaco ts orient

WHINE. sve 1G.) 96? tea i DE Yi ninon tie sient 8 lavonyas p'lissujes ie VV oO] sorgiia yersoleyo tert inesada onilstud tt lo spieldegdrin set ogg perth raviegst aun! Hartndus Stlide! yneet valet we rue neoenal epee ant oi Saul kes Hawi) ylaiioinol line Sear G 07 SBbie fot soarueuct yet oiiGee! yRUSHFb bose eilviely ar shiny. oO) bsoieiy el geititod |aaeddeady oT yet gael des HOU BeOMUG YPInSUER Pela! ea Or sage aL Geka Sele ell te Sac adas ls rays Wald eetbte Widdlone thw poligd of) oseiiase ismaaslony a prteasinen aleve

fo Tosa Mat adenine at paibligd dry cagwot bateowdb Oas anirtmct-non ais. tad airipl Wilh SHER fe SVR CoS 2 Bue ST Alanon peiaéan qu Bteaueiatud Guletalian eiiPeansrii ot belised rales) itt SoVRAUIA GO AoiopieiC s1Bin BRAS 10. Hiv ctsntysw. iainolsuc SvoW tn bis norsineqgn 2 yj 1Sqia1g;

Sao Me SOUS. STO 2 Sah Sotiris an hate ef aiigll adi? Ale lsog wiO StL Guam sagge IsnCaratoty SP SASH SW eediens WO to eeacove ws

efaseieeue prince aft payseqag homey sqm

JO BPG Ob iG? Sb TRB aoe aif TG niagara Tuy ahora ey

; Inala rahiandos Duk: * tom Tar".

Yi Re Male

Beni) grtyt

Benes (Td lees te thus ak

Stet In ES co

Please note, | have provided proof of insurance for the company that would be completing the light installation on the next few pages.

VRS. hey Tee Ti) a ee ' Rasa so GS) |e eons

7. ry ‘ny

rr

ationilolitiog ac bi Jed vegan in? afl iol eonsieanite jigia nsoving Svan | alen s2gal4y Boost wet ta: or no olntstery: laos

a ACCOR CERTIFICATE OF LIABILITY INSURANCE patra

THES CERTIACATE &S SSSUED AS A BATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTWICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELO. THES CERTFICATE OF INSURANCE DOES NOT CONSTTIVIE A CONTRACT GETWEEN THE ISSLENG PTSURERSS), AUTHORIZED bennett en enn cnn nines

1! SUBROGATION IS WAIVED, subject to tre terme and conditions of the policy, certain poticies may require an endorsement Awatemest en | ee os

Jiien Sherain

aoe as Uiactie bandcon bin (585) 416-4100 [ieee (585) 406-4960 1080 Pinsiont-Victor Road SarQnceypantercireance CoM oti RRR Arr COMER mace | Prtstont MY 14534 agua (MGM trewence Compery $4708 ——: = Pannsyharia Mortacturers Indscona@y Company 44

Roe Sched inc, DBA: Holiday Lighting of Rochester Ts

2004 Gieseocd Ave 8128 r= ie

etn & -

Rochester my 14018 | emmane

EXCUUSIONS AND CONDSTIONS OF BUCH POLICIES. LIMITS SHOWM MAY HAVE BEEN REDUCED BY PAID CLAMS.

swear nlite Ta Pe A = COMMERCHA GENERAL UAIELATY EACH OCCURRENCE 3 2.000,000 PEARMROE Yes RETEST | crnecsemne [36] ocoun PRESSES a cctanence) | 8 100,000 hey s 70,000 at cPooossos2 ovtorzeas | o1torz027 avmamy [5 2000000 = | PERSONAL & ADV DLLRTY ua Fer omen socnecate |p 4900000 onen. : SCORE LOY s 1,.00R000 — ante maT BOOLY PULERY grer parece) 5 ay | owe SsceDAeD CAD00O4404 Ov/t2028 | O1NO2027 | BOORLY BURY Per eciteeg |S wo asta ROPER OXURE 7 AUROS ONLY autos Cony Lie ected | 8 menraie 19d oon LEACH OCCURRENCE Pod B excens Line 80200 1202755 ovtorenas | ovro27 | ocseace 5 5.000.000 nevewmom 3 10.000 AREY PRED RE TORPRETMERIEXECTIVE en EL. EACHACCIDENT s aeootery 2 He EL OREASE -EAEMPLOWEE | $ i @nott wate OF OPERATIONS poe EL OnEASE-POUCY LAAT _}5 ———y = = CERTIFICATE HOLDER CANCELLATION

SHOULD ANY OF THE ABOVE DESCRIBED POLICIES OF CANCELLED BEFORE THE EXPURATION DATE THEREOF, NOTICE WILL. BE DELIVERED it FLU ROC Ermerprtoes LLC ACCORDANCE WATO THE POLICY PRRCreEaONS.

rd Webster NY 14580 a ia

© 1988-2816 ACORD CORPORATION. AS rights reserved. ACCORD 26 (28th) The ACORD name end iogo are registered marks of ACORD

— a : aac, resis hie what al re am.

2 woe VE SAL WG TAS EARS os y eg

i} a dee {s Re ere TES a poe

pie * eis rr it 2 a ale 7 Folate Os Write | DANS sau

ry

Ee as ey a ERD eM i= Sone ie fy — be oN ; ” te im» ott) . we edt igi Sees eee teen a ; — ee Niece eres ie ery Fe } - Te ae = F i a 1 ll 7 a | he — a = Ht a = —— etal: cet =e « f £4 | = : 7 mS - | al - SE wor a — ss er E ake — —— om Tes — 7 ie a Te } - a # i na fi | a a 1 iach yea tee My

ul a@ ts i 4 - pa — _— —" et ™ =a "; i he a -_- - a > | —- sa =e, ts 7 ce - A : | ~ a aa i f - ; 4 ——— — mf 4 | a 7 uw! 7 bs « al 7 = - so : a — i Sa = eve - . «= . | oe i P i ; a a — 1 = =a te see - #1 «@s a ed —=—— ——— oes = ES =a = = sonal ie a ~~ shy die = 1 ai, ane se | / : et na tes ; : —— yo z a ifm ve i. na ay UW, aa ese ae

<e

s

Mew York ate meurance Fund PO Bax 60600, Albany, NY 12206

AAAABA 464248351 INNOVATIVE RISK CONCEPTS, INC. 178 SOUTH MAPLE AVENUE

FEDGEWOOD NJ 07450 POLICYHOLDER CERTIFICATE HOLDER ROC SCHOTT INC. DBA FISH WINDOW RLJ ROC ENTERPRISES LLC CLEANING ROCHESTER 790 RIDGE RD 2604 ELMWOOD AVE 128 WEBSTER NY 14580 ROCHESTER NY 14618 POLICY NUMBER CERTIFICATE NUMBER POUCY PERIOD DATE 22643 003-3 380478 TO oc2i2er2027 TH2026

THIS iS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE FUND UNDER POUCY NO. 26430033. COVERING THE ENTIRE OBLIGATION OF THIS POLICYHOLDER FOR WORKERS" COMPENSATION UNDER THE NEW YORK WORKERS COMPENSATION LAW WITH RESPECT TO ALL OPERATIONS IN THE STATE OF NEW YORK, EXCEPT AS INDICATED BELOW, AND, WITH RESPECT TO OPERATIONS CUTSIDE OF NEW YORK, TO THE POLICYMOLDER'S REGULAR NEW YORK STATE EMPLOYEES ONLY.

i YOU WISH TO RECEIVE NOTIFICATIONS REGARDING SAID POLICY, INCLUDING ANY NOTIFICATION OF CANCELLATIONS, OR TO VALIDATE THIS CERTIFICATE, VISIT OUR WEBSITE AT HTTPS:2A0WW.NYEIF.COMICERTICERTVALAS?. THE NEW YORK STATE INSURANCE FUND [3 WOT LIABLE IN THE EVENT OF FARURE TO GIVE SUCH NOTIFICATIONS.

THIS POUCY DOES NOT COVER CLAIMS OR SUITS THAT ARISE FROM BODILY INJURY SUFFERED BY THE OFFICERS OF THE INSURED CORPORATION.

PRESIDENTE

CHARLES B SCHOTTLAND

ONE OF ONE

ROC SCHOTT INC. DBA FISH WINDOW

CLEANING ROCHESTER THE POLICY INCLUDES A WAIVER OF SUBROGATION ENDORSEMENT UNDER WHICH NYSIF AGREES TO WAIVE ITS RIGHT OF SUBROGATION TO BRING AN ACTION AGAINST THE CERTIFICATE HOLDER TO RECOVER AMOUNTS WE PAID IN WORKERS’ COMPENSATION ANDYOR MEDICAL BENEFITS TO OR ON BEHALF OF AN EMPLOYEE OF OUR INSURED iN THE EVENT THAT, PRIOR TO THE DATE OF THE ACCIDENT, THE CERTIFICATE HOLDER HAS ENTERED INTO A WRITTEN CONTRACT WITH OUR INSURED THAT REQUIRES THAT SUCH RIGHT OF SUBROGATION BE WAIVED.

THIS CERTIFICATE 5S SSSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS NOR INSURANCE

NEW YORK STA FUND

by bn

DIRECTOR INSURANCE FUND UNDERWRITING VALIDATION NUMBER: 44697081

sain Me v4 ON.) VEY eu |e —_ | e FPA ET

LA Se MUTT ACHSSMOG SRAANC A ky STADE RTOLS

a 7 Pa mn ‘a nF =© MIF ee ee — a — Ad * tpn Te oa , A ELTA | | a xl i 7 ; | a) : < ser aa m ft "W i ' I on ae an | te — Linas ee — —— oe ie te? — L — | : _— a is ibe a HL pa i | ae: 4 e pith od il Bort ee a ——e ea — =_ —— wT — fac (ite =A7, ws =a Et se ™ a 2 pie a a P m4 mm, "+ 41 “= * i — sath ~ = a Cam eae en = 7+ ity vel te aa biis* << J ai . * ° toe RVSNTAD STBEO GS THATS TH, oo Raya ge 1 oe TRS CA RL At DS. Sat ed 74 so ER H Ie “Sis Woes a8 A Tee Bh et 4 Pe Seer5 pass . Le wat as OKA Hite Peet) hand) ae EAAVE Gi La Be used Se atZ Em = ¥ ce ES “ee | by - ii sok: SL itn Ut a Fr Pin Ce ee a uM ve vale Tie pp 7 . ~ = iT nm 2S eae uy wale te, oi Ske SE oh 5 “% a = ~u Mo tte Fh ne . Tas sl 7 *" ere is. Fe we = - wi “ae » Tie «=e aa an he ita Datgt be) | et ia “ = 2 | TTA q = bi se ”

wT SS Lieath TF ahcwn AR,

«.

Short Environmental Assessment Form Part I - Project Information

Instructions for Completing

Part 1 — Project Information. The applicant or project sponsor is responsible for the completion of Part 1. Responses become part of the application for approval or funding, are subject to public review, and may be subject to further verification. Complete Part 1 based on information currently available. If additional research or investigation would be needed to fully respond to any item, please answer as thoroughly as possible based on current information.

Complete all items in Part 1. You may also provide any additional information you believe will be needed by or useful to the lead agency; attach additional pages as necessary to supplement any item.

Part 1 — Project and Sponsor Information

Bloom & Blend Webster LLC Name of Action or Project:

B&B Strip of Lights Project Location (describe, and attach a location map):

790 Ridge Rd, Webster NY 14580

Brief Description of Proposed Action:

36 linear feet of stationary decorative LED exterior lighting along the northeast side of the building to enhance the property's appearance and improve customer visibility and wayfinding.

City/PO: State: Zip Code: Webster NY 14580 1. Does the proposed action only involve the legislative adoption of a plan, local law, ordinance, NO YES administrative rule, or regulation? If Yes, attach a narrative description of the intent of the proposed action and the environmental resources that [] may be affected in the municipality and proceed to Part 2. If No, continue to question 2. 2. Does the proposed action require a permit, approval or funding from any other government Agency? NO YES If Yes, list agency(s) name and permit or approval: Planning board application approval [Ps] 3. a. Total acreage of the site of the proposed action? \.? acres b. Total acreage to be physically disturbed? oO acres c. Total acreage (project site and any contiguous properties) owned or controlled by the applicant or project sponsor? V2 acres

4. Check all land uses that occur on, are adjoining or near the proposed action: {JJ Urban ([] Rural (non-agricuiture) (1) Industrial [=] Commercial (] Residential (suburban) (] Forest (7) Agriculture (C) Aquatic ([[] Other(Specify): [_] Parkland

Page 1 of 3 SEAF 2026

5, Is the proposed action,

N/A

a. A permitted use under the zoning regulations?

b. Consistent with the adopted comprehensive plan?

[SN]| RN) &

6. Is the proposed action consistent with the predominant character of the existing built or natural Landscape?

3

7. Is the site of the proposed action located in, or does it adjoin, a state listed Critical Environmental Area? If Yes, identify:

8. a. Will the proposed action resuit in a substantial increase in traffic above present levels?

b. Are public transportation services available at or near the site of the proposed action?

c. Are any pedestrian accommodations or bicycle routes available on or near the site of the proposed action?

SINS 3/8 |/3/0

9. Does the proposed action meet or exceed the state energy code requirements?

If the proposed action will exceed requirements, describe design features and technologies: will not exceed.

Zz o

E|

10. Will the proposed action connect to an existing public/private water supply?

If No, describe method for providing potable water:

this project has nothing to do with water

11. Will the proposed action comnect to existing wastewater utilities?

If No, describe method for providing wastewater treatment: this project has nothing to do with water

12, a. Does the project site contain, or is it substantially contiguous to, a building, archaeological site, or district which is listed on the National or State Register of Historic Places, or that has been determined by the Commissioner of the NYS Office of Parks, Recreation and Historic Preservation to be eligible for listing on the State Register of Historic Places?

b. Is the project site, or any portion of it, located in or adjacent to an area designated as sensitive for archaeological sites on the NY State Historic Preservation Office (SHPO) archaeological site inventory?

13. a. Does any portion of the site of the proposed action, or lands adjoining the proposed action, contain wetlands or other waterbodies regulated by a federal, state or local agency?

b. Would the proposed action physically alter, or encroach into, any existing wetland or waterbody?

If Yes, identify the wetland or waterbody and extent of alterations in square feet or acres:

Nim © Be & lel & kz

OO O Oe Of] Of © SOOO Ol N\sO00

4

Page 2 of 3

r .

14, Identify the typical habitat types that occur on, or are likely to be found on the project site. Check all that apply: OShoreline O Forest [[] Agricultural/grasslands [_] Early mid-successional (Wetland O Urban [mi] Suburban

15. Does the site of the proposed action contain any species of animal, or associated habitats, listed by the State or YES Federal government as threatened or endangered? CO

16. Is the project site located in the 100-year or 500-year flood plain? YES YES

17. Will the proposed action create storm water discharge, either from point or non-point sources?If Yes,

a. Will storm water discharges flow to adjacent properties?

b. Will storm water discharges be directed to established conveyance systems (runoff and storm drains)? If Yes, briefly describe:

SSISEREIRIE

18, Does the proposed action include construction or other activities that would result in the impoundment of water NO | YES or other liquids (e.g., retention pond, waste lagoon, dam)? If Yes, explain the purpose and size of the impoundment:

C)

19. Has the site of the proposed action or an adjoining property been the location of an active or closed solid waste NO | YES management facility? If Yes, describe:

4) 20.Has the site of the proposed action or an adjoining property been the subject of remediation (ongoing or NO | YES completed) for hazardous waste?

If Yes, describe:

Alo

21. Is the project located within, or within 4 mile of, a disadvantaged community? If No, could impacts from the project affect a disadvantaged community? If Yes to either question in 21, answer the following question. a. Identify the potential pollution impacts of the project, either direct or indirect, that may occur within the

disadvantaged community (e.g., wastewater discharges, air emissions, noise, odors, solid or hazardous waste generation or management):

NO ka

ira

1 CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF

MY KNOWLEDGE Applicant/sponsor/name:_Alyssa Connors Date: 7/29/26 Signature: Title: Coe =

Page 3 of 3 SEAF 2026

7 ee

l dehy YALE Nf, ERT gah, ti) Pll 4 * Eau fj ee cd try ha eegrti fas any are rasta § ie wae 4] Pe hit Lt I I : fansite hie wel cy oat tae) laura TD teu 19 Qopip es | sh [xy “iy r t hottie) Bay 7 i re wy niet? at | na t: wed agheetiadl ii ale’ area vue ene te wee Nea at viv rn Pate UCC Gacy te ue ae A = | Sorsyind Lg: ame Matthies tena Sd

chem "sens Peay t ty ; : “yirte, Liason PSE lige Wor ett oe tyviits wl taieaeioan speck $e es pees —_

i

ae a MHRA ce [eng etndel Canes sigehriaeirans tore Bi) BOIS Loe moti S i a WA A Raed. =, 4 .

i } Nj SOM iateee ni! Gave) Bice (ase leo EE | peri he wee ene vf | {N] Tetindiiniaebns Hon ternitseawey Validate GhL il! RRsat! thc We TOUTE oat hi =| gteesenb i tesert ae¥ 4!

, i | |

“it | Qo Tease rr aientba ann 1 out) ity Heke at Paltocaee Hiei eit oma sey es redlteat ety daw Mia pitting | arr ail pont a

ie Poila Apratsl CY ee

[ategeery te) habeas pe

“Gstrah nei alee a NSRLEU Lanter ttvyyt Saal +

wh fer ffith other cheap " ode 1" TB alate eae tll malices et ii

lee di

ee

nag Dipii ever sent an} inka haaqenee oi bee aie Sa! ell 0 Pyaitiaste Mts aittt | salanian eee |

}

4 ‘ e

a

ee ike faving hat ad, ul

lees —s

*r

ee a ee eos tt Sty

ware pian orion oy anicat a an) Peer wm rer Wopset ke oT a eI “arenve qe ati iw, tht aed gents: thea He

—

*

Je uiLinrin hematite Aas mera aT eas et ayes ah «|

“vhreernere dy seotiiprtlicteg bof, Byte alt iy bern linia yd 1

alts be capt bien fis PU oh ess 1 hae He Wa The pati: es a

'

; wtherdilerus wisi aw St o*TedLt “tha gad 0 tread fh bysthety tlh Sa) ebiuniditt abate Piiteigg alt Nthinwtt p

aap htt eh oncitt “ ib ” Noone ae. oft TD ae ty Pi il oostedtaall: Oe) ee ed Be eet Ahmet hye teabbits Mbayeaze

AMSTEL Er! fae feet fegparal | Lt, 4 ASNT RL ETGRt Ves, 4k AT 2 SAMA UMP 4 AGN EAGT ett ¥7 wi Wallin a 14. | | AAO | —- ae = = = a EE eet teeter ieieeitanee ins alla ’ | OO = id P iuremeeti hy 5 _ —— = _ — SwAltetisie '

HA Aba

OWNER’S AFFIDAVIT (Sign and return if property owner is different than applicant)

Agb¢e? slery~t(G do hereby certify that | am an owner and/or contract purchaser of properly involved in this request and that the foregoing statements, answers and supporting documentation submitted are in all respects true and correct to the best of my knowledge and belief. lf this application is granted approval, all actions shall be in accordance with the terms of that

approval.

this jS SUX Foll + RE

. Wane decomstye erterie® Lr ede

RLS Roc Ewten Pe (SES Lee NAME OF PROPERTY / BUSINESS OWNER

SIGNATMRE/OF PROPERTY/BUSINESS OWNER

/ DATE

11

why a aka

: =< ‘ ae 4, x y) sj

= » aM! ASIA SCs f

‘. i

alt & =e A sco sa file |

vA :&

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 oka 6) Smal) ot hayes

SMAMIGSD Bag iOS AATSAW BMT WO

URAIAOS VAN TE MOM ey OF

iad WY to WoT We SONU To vino choy welt lo SIsicl ell tn eavotgete: 10 works ob eer | } sie i's ghs a J teu gu Sas An toe ~s nie ale Peet ferns oni tiy he eeorh es PA Ub tes At mahigtts Orusi onli 8 Pec ish ai Maylll vores efi ; r DENN geet Lgl

ae

Be ee | OATAS

SVR IaataF fet aetna

DISCLOSURE OF INTENT TO REQUEST TAX INCENTIVES, ABATEMENTS, OR EXEMPTIONS

Have you currently applied for, or intend to apply for any tax incentives, abatements, or exemptions?

Yes

-—— No K If YES, would you agree to enter into a Host Community Agreement* (HCA) with the Town of Webster?

Yes

No

.—» {if NO: If you apply for or receive any tax incentives, abatements or exemptions in the future, would you agree to enter into a Host Community Agreement (HCA)?

Yes No a

190 Lidge 2A Bloor + Blend Whoster LLC

NAME OF PROPERTY / BUSINESS OWNER

SIGNATURE OF PROPERTY/BUSINESS OWNER

q/29/2u , DATE

* A Host Community Agreement (HCA) is an agreement between the business/property owner, wherein the business/property owner recognizes that the Town provides services which benefit the business/property and the owner desires to compensate the Town for such services, by making payment to the Town (and to make the Town whole in regard to property taxes) by entering into this agreement to acknowledge the Town’s cost of providing services to its residents and property

owners. \nnok SPace 7

VERO aE Para SUE AA AS? pT MOAT AGA eS SyiTManns KEE

ealt ee “ b teense

dM) ins Gatsce euler xet vis it viqas of boetd va cor peiqun yoirenne ucy evel y PRONG 48

aay

— taeteres er

Mi (ear) IS NeS yA yh rhe btald BONY leis Gl Soe Woy eS ayy: ~

~

- wee t Lae shh 7 se) / «af | a a? a

7 4 mM cncuginess 36 elpemetots coviltiecni x6! YG evita w rel ylane voy KH «- MACH) Ine ura WeLuTtOS 10H 6 ON) Hote ol Seige Ut Did ord ny

aot — Soap ro

' ° f J i . wea ee eo a AAS SSaMIeLs | VIHA OS AG BMA ;

ee

BAAD SBANS UY TAOS AO RFU TAUB

TAL)

PO Egniqneceniaunl ma eeeswist TeSTeope he (ACH MSs, yer gnniol tara * Sry itera dain aeniy ss valine ry wor Srl tail 2esiinoos" Me einoGntestapiaud Bot (ole poate wt smiling done aot ine ait BIGTEGO OOS iOF 2a we DONE YORE AaZOn wus le AW Oo eves ad Bax, ere Bohs: Sh EAS ff! SHO SH PaO! Wisaiwea: vied bes arenes: oto) aanrries Gove Eo wey] ot opholvceion et fesattaay UG

Sees