Lorraine, NY · Jefferson County

No notary required

Agricultural Data Statement

This statement accompanies subdivision approval applications for projects on certain properties in or near an Agricultural District with a farm operation.

What this form is

The Town of Lorraine requires this statement with subdivision approval applications for projects on property within an Agricultural District containing a farm operation, or within 500 feet of a farm operation in an Agricultural District. It asks for the applicant’s contact information, a project description, nearby farming operations’ names and addresses, and the project’s exact location. Attach a tax map or clearly drawn map showing the project relative to the identified farming operations.

Who needs it

Applicants seeking subdivision approval for projects on qualifying property in or near an Agricultural District with a farm operation need to submit this statement.

How to submit it

Submit it to the city department named on the form; check the city website for current contact details.

About notarization

This statement has no notary requirement; attach the requested tax map or clearly drawn map showing the project and identified farming operations.

How to submit this form

  1. 1

    Download The Statement

    Download the Agricultural Data Statement for the proposed project.

  2. 2

    Complete The Statement

    Provide the applicant’s contact information, project description, nearby farming operations, and the project’s exact location.

  3. 3

    Gather The Map

    Attach a tax map or clearly drawn map showing the project relative to the identified farming operations.

  4. 4

    Submit With Your Application

    Submit the statement with the required subdivision approval application to the city department named on the form.

Frequently asked questions

Do I need a notary for the Agricultural Data Statement?
No. The statement has no notary requirement. Attach the requested tax map or clearly drawn map showing the project and identified farming operations.
Who must submit the Agricultural Data Statement?
Applicants must submit it with subdivision approval applications for projects on property in an Agricultural District containing a farm operation, or within 500 feet of one in an Agricultural District.
What information does the statement request?
It asks for the applicant’s name and contact information, a description and exact location of the proposed project, and the names and addresses of farming operations within 500 feet.
How do I submit the Agricultural Data Statement?
Submit it to the city department named on the form; check the city website for current contact details. Attach a tax map or clearly drawn map showing the project relative to identified farming operations.

Need something notarized?

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