Settlers Irrigation District

							                     Settlers Irrigation District

                      Land Use Change Application
                         Enclosures: $ 300.00 plan review fee
                                 Two (2) sets of plans
                                     Calculations
                               Single Assessment Form


General Information:
1.________________________________________________________
  (Proposed name of development)

2.________________________________________________________
  (General Location-Section, Township, and Range)

3.________________________________________________________
  (Legal Description- Attach metes and bounds description as recorded)

4.________________________________________________________
 (Current owner of record- Attach copy of warranty deed)

__________________________________________________________
(Address)

5.________________________________________________________
  (Developer)

__________________________________________________________
(Address)

6.________________________________________________________
  (Engineer)

__________________________________________________________
(Address)

__________________________________________________________
(Contact person)                               (Phone)

7. Acres___________________; Number of Lots__________________;
   Number of Lots/Gross Acre__________________________________
8. Is irrigation water to be provided to property? _____________________

If yes answer the following:

   a) Proposed delivery point_______________________________________
                             (Canal or Lateral)

   b) Present delivery point for this land______________________________

   c) Type of System

           1. Gravity ________________________________________________
                      (Pipe or open ditches)

           2. Pressure Irrigation________________________________________


           3. Who will own, operate and maintain the pressure irrigation system?

           __________________________________________________________

   9. Other irrigation facilities affected by the development

       _____________________________________________________________
       (Canals, Lateral, and/or Drains)

   10. What are the proposed changes to the irrigation facility/ies

       _____________________________________________________________
       (Relocation, Pipe, Etc...)

   11. Drainage Plan _________________________________________________
                     (SID does not accept any storm drainage into its facilities)


__________________________________                      ______________________
(Signature)                                             (Date)


NOTE: Settlers Irrigation District will require a Single Assessment to the
Homeowner’s Association for the operation and maintenance of the
pressure irrigation system. SID will not own, operate, or maintain the
pressure irrigation system without the capability of assessing the
Homeowner’s Association for all lots within that development.
                     Single Assessment Form



Date_________



Board of Directors
Settlers Irrigation District
P.O. Box 7571
Boise, Id 83707



In accordance with Idaho Code 42-701, the ______________________
Requests that for purposes of assessment all lots be combined into a single
assessment number.

For now, the billing should be made to:

                                      _____________________________

                                      _____________________________

                                      _____________________________

Sincerely,