(1)
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Name and identifying title of subdivision:
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(2)
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Name or agent of subdivider:
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Name:
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Address:
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Phone:
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(3)
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Professional engineer/licensed land surveyor:
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Name:
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Address:
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Phone:
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(4)
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Location of proposed subdivision:
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(5)
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Names and addresses of abutting owners:
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(6)
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General description of subdivision and estimated number of units:
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Number of acres: ____________
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(7)
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We agree to comply with the village ordinances, subdivision regulations
and Official Village Map as presently in force in the Village of Colonie:
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Signature of professional engineer or licensed land surveyor
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Signature of subdivider:
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(8)
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Amount of fee accompanying this application:[1]
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(9)
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The undersigned hereby requests review and approval by the Village of
Colonie Planning Commission of the above-identified subdivision plat.
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Signature
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Title
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Date
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STATE OF NEW YORK
COUNTY OF ALBANY
VILLAGE OF COLONIE
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ss::
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______________________, being duly sworn, deposes and says
that he is the owner and/or developer of the subdivision known as ______________________,
which subdivision is herewith submitted to the Village Planning Commission
of the Village of Colonie, New York, for its approval, pursuant to the Village
Law of the State of New York and other statutes and ordinances in such cases
made and provided.
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That deponent has examined personally or has caused to be
examined the records of the County of Albany relating to conveyances, deeds,
wills, etc., and has examined the assessment roll of the Town of Colonie and
the Village of Colonie and has inspected the premises shown upon the aforesaid
development map.
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Deponent states that, from his examination of the aforesaid
records and to deponent's actual knowledge, the map or plan as submitted
herewith is true and correct in every detail and correctly sets forth the
owners of adjoining lands.
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That this affidavit is made as an inducement to the Village
of Colonie Planning Commission for approval of the aforesaid subdivision plat
and is submitted at the public hearing held on the ________ day of _______________,
19 _____.
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_________________________________
Signature
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Sworn to before me this ________ day of ____________, 19
______
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____________________
Notary
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