Alexander, NY · Genesee County

No notary required

Agricultural Data Statement

This statement is completed by applicants seeking certain land-use approvals for projects near a farm operation in a certified Agricultural District.

What this form is

The form gathers information for special use permit, site plan, use variance, or subdivision applications requiring municipal review when the property is within 500 feet of a farm operation in a certified Agricultural District. It asks for applicant and owner details, the project type and location, agricultural district and farming status, and nearby farm operations. Additional sheets may be attached if needed.

Who needs it

Applicants for the listed approvals must complete this statement when the property is within 500 feet of a farm operation in a certified Agricultural District.

How to submit it

The form says the referral agency must submit a copy with the referral to the County Planning Department; it does not give applicant filing instructions. Check the city website for current contact details.

About notarization

This statement is signed without a notary; the applicant and, if different, the owner sign, and no sworn attachment is specified.

How to submit this form

  1. 1

    Download The Statement

    Download the Agricultural Data Statement PDF.

  2. 2

    Complete The Form

    Provide applicant and owner information, application type, project details, and answers about the parcel and nearby farm operations.

  3. 3

    Gather Additional Sheets

    Attach additional sheets if needed to list farm operations within 500 feet of the parcel.

  4. 4

    Submit With The Referral

    The referral agency submits a copy with the referral to the County Planning Department.

Frequently asked questions

Who completes the Agricultural Data Statement?
The applicant completes it for certain special use permit, site plan, use variance, or subdivision applications involving property near a farm operation in a certified Agricultural District.
What information does the statement request?
It asks for applicant and owner details, the application type, project description and location, agricultural district and farming status, and nearby farm operations.
Do I need a notary for the Agricultural Data Statement?
No. The statement is signed without a notary; the applicant and, if different, the owner sign, and no sworn attachment is specified.
How do I submit the Agricultural Data Statement?
The form says a copy must accompany the referral to the County Planning Department. It does not give applicant filing instructions; check the city website for current contact details.

Need something notarized?

This Agricultural Data Statement doesn’t need a notary — but if you have another Alexander form that does, a commissioned online notary can help.