Application for Preliminary Plat Approval

INSTRUCTIONS

Print or type clearly. Use additional sheets if necessary. All required attachments and support documentation shall be submitted with this application form. Incomplete or inaccurate applications may delay public hearing or decision dates. The completed application package must be submitted to the County [appropriate county staff member] by the subdivider or a designated agent and shall be in compliance with the requirements of the County Subdivision Regulations. Each application must be accompanied by the required administrative fee.

APPLICANT INFORMATION

1. Subdivider Name ______________________________________________________
  Address_____________________________________________________
  Phone Number __________________________________
   Signature________________________________________________ Date_________________________

2. Agent (if any) Name____________________________________________________
  Address_____________________________________________________
  Phone Number________________________________
  Signature_________________________________________________ Date _________________________

3. Engineer/Surveyor Name_________________________________________________
  Address______________________________________________________
  Phone Number _________________________________
  Signature__________________________________________ Date _______________________

SUBDIVISION INFORMATION

4. Name of Subdivision_______________________________________________________   (Indicate if this is a succeeding subdivision, phased subdivision, or resubdivision)

5. This is a Type One_____ Two_____ Three_____ Four_____ Subdivisions (check one)

6. Number of lots:_____ Total acreage: _____Acres_____ Size of smallest lot: _____Acres

7. Municipal planning and platting jurisdiction (if applicable):  __________________________________________

PRELIMINARY PLAT APPLICATION - PART TWO

SUPPLEMENTAL INFORMATION

8. If this is a succeeding subdivision, provide detailed attachments indicating the relationship between the proposed subdivisions and the previous subdivision.

9. If this is part of a phased subdivision, attach a master plan of all phases indicating the current proposed phase and an anticipated phasing schedule.

10. If this is a resubdivision, provide a reference to the original plat with an explanation of the proposed changes.

11. Supporting documentation required for the preliminary plat review as defined by the County Subdivision Regulations shall be attached to this application.

12. The required number of copies of the preliminary plat map as specified by the County Subdivision Regulations shall be attached to this application.

13. A draft copy of the disclosure statement shall be attached to this application and shall be in accordance with the standardized format provided in the County Subdivision Regulations.

PROCEDURAL INFORMATION (to be completed by County Staff)

14. Date application received by County__________________ Signed _____________________________

15. Date preliminary plat deemed complete _______________  Signed _____________________________

16. Date of public hearing ____________________________

17. Date of preliminary plat approval by County ____________________________