Leicester, NY · Livingston County

No notary required

Agricultural Data Statement

This statement documents a proposed project and nearby farm operations for applicants seeking certain municipal approvals on or near agricultural district property.

What this form is

The Agricultural Data Statement accompanies applications for special use permits, site plan approval, use variances, or subdivision approval when municipal review is required and the property is in or near a farm operation in a certified agricultural district. It asks for applicant and project details, farming activity and nearby farm owners. Applicants must attach a current tax map showing the project site relative to the identified farm operations.

Who needs it

Applicants seeking the listed municipal approvals for property in an agricultural district containing a farm operation or within 500 feet of one need 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 document is signed and dated without a notary; it asks the person completing the form to provide their name and title.

How to submit this form

  1. 1

    Download the Statement

    Download the Agricultural Data Statement PDF.

  2. 2

    Complete the Form

    Provide applicant and project details, property location, acreage, farming information, and nearby farm-owner details.

  3. 3

    Gather the Tax Map

    Attach a current tax map showing the project site relative to the farm operations identified in the statement.

  4. 4

    Sign and Date

    Enter the name and title of the person completing the form and the date.

  5. 5

    Submit to the City

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

Frequently asked questions

What is the Agricultural Data Statement for?
It provides information about a proposed project and nearby farm operations for certain applications requiring municipal review and approval on or near property in a certified agricultural district.
What should I attach to the statement?
Attach a copy of the current tax map showing the proposed project site in relation to the farm operations identified in the statement.
Do I need a notary for the Agricultural Data Statement?
No. The statement is signed and dated without a notary; the person completing it provides their name and title.
How do I submit the Agricultural Data Statement?
The document does not specify a submission address or method. Submit it to the city department named on the form and 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 Leicester form that does, a commissioned online notary can help.