Nichols, NY · Tioga County
Agricultural Data Statement
Applicants complete this statement for certain municipal applications involving property near a farm operation in an Agricultural District.
What this form is
This statement is required for a municipal review application for a site plan approval, special use permit, or use variance proposed within 500 feet of a farm operation in an Agricultural District. The applicant provides project and property details and identifies nearby farm operations. The municipal clerk records notice dates, and the municipal review board reviews the statement as part of considering possible project impacts.
Who needs it
Applicants for a site plan approval, special use permit, or use variance involving property within 500 feet of a farm operation in an Agricultural District complete Part I.
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 is signed and dated without a notary; the form lists no notarized attachment or sworn step.
How to submit this form
- 1
Download the Form
Download the Agricultural Data Statement PDF.
- 2
Complete Part I
Enter applicant and project details and list farm operations within 500 feet of the parcel.
- 3
Attach a Separate Sheet if Needed
Attach a separate sheet if necessary to list farm operations.
- 4
Submit to the City
Submit the completed statement to the city department named on the form; check the city website for current contact details.
Frequently asked questions
- Do I need a notary for the Agricultural Data Statement?
- No. This statement is signed and dated without a notary, and the form lists no notarized attachment or sworn step.
- Who completes the Agricultural Data Statement?
- The applicant completes Part I for a site plan approval, special use permit, or use variance proposed within 500 feet of a farm operation in an Agricultural District.
- What information does the statement ask for?
- It asks for applicant and owner details, application type, project description and location, and information about nearby farm operations, including their addresses and tax map numbers.
- How do I submit the Agricultural Data Statement?
- The form does not give a submission address or contact method. Submit it to the city department named on the form; 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 Nichols form that does, a commissioned online notary can help.