Application by chrstphr

VIEWS: 16 PAGES: 3

									                                               PRELIMINARY PLAT
                                               APPLICATION FORM
                                                     (PLTP)
PROJECT NAME (PRINT):
COMPUTER ASSIGNED PROJECT #:
ASSIGNED FILE #:

CORRESPONDING PRE-APPLICATION CONFERENCE PROJECT NAME AND IRC
ASSIGNED FILE NUMBER: SD-_______-_______-_______
OWNER: (PRINT)                                                         AGENT: (PRINT)

NAME                                                                   NAME

ADDRESS                                                                ADDRESS

CITY               STATE                                               CITY               STATE
___________(____)______-__________                                     ___________(____)_______-____________
ZIP         PHONE                                                      ZIP          PHONE

FAX NUMBER                                                             FAX NUMBER

EMAIL                                                                  EMAIL

CONTACT PERSON                                                         CONTACT PERSON
                                    ____________________________________
                                      SIGNATURE OF OWNER OR AGENT
PROJECT ENGINEER: (PRINT)                                              PROJECT SURVEYOR: (PRINT)


NAME                                                                   NAME

ADDRESS                                                                ADDRESS

CITY               STATE                                               CITY                     STATE
__________(_____)______-_____________                                  ___________(_____)______-____________
ZIP   PHONE                                                            ZIP                PHONE

FAX NUMBER                                                             FAX NUMBER

EMAIL                                                                  EMAIL

CONTACT PERSON                                                         CONTACT PERSON


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SITE TAX ID#'S:



PROJECT USE:________________________________________________________________


IS ALL OR A PORTION OF PROJECT IN "ENVIRONMENTALLY SENSITIVE" AREA AS
ADDRESSED IN THE PROJECT PRE-APPLICATION CONFERENCE?
     YES __________         NO__________
• ZONING:_______________________CLUP:__________________________________
• TOTAL (GROSS) ACREAGE OF PARCEL:__________________________________
• AREA OF DEVELOPMENT (NET) ACREAGE:________________________________
• TOTAL NUMBER OF LOTS:________DENSITY (UNITS PER ACRE):____________

**PLEASE FILL-OUT APPLICATION SUBMISSION CHECKLIST**
===================================================================
FOR OFFICE USE ONLY:
DATE RECEIVED:____________________/_____/_________
DATE APPLICATION COMPLETE:_____________________/_____/_________
SUBDIVISION FILE NUMBER: SD-_____-_____-_____
REVIEWING PLANNER:_________________________________________________

                                        PRELIMINARY PLAT
                                 APPLICATION SUBMISSION CHECKLIST

          NOTE: “N/A” may be marked in YES column if “Not Applicable”

MATERIAL                                                                                         YES       NO
1.                   Formal Pre-Application Conference Held                                      ___       ___

2.                   Fee       < or = to 10 acres:                     $700.00                   ___       ___
                               > 10 acres:                             $950.00                   ___       ___

3.                   Completed Preliminary Plat Application Form                                 ___       ___

4.                   Ten (10) Copies of the Preliminary Plat                                     ___       ___

5.                   Two (2) Sealed Site Surveys                                                 ___       ___

6.                   Two (2) aerials of site with project
                     overlay, showing surrounding 200 feet                                       ___       ___

7.                   Two (2) copies of the Owner’s Deed                                          ___       ___

8.                   Letter of Authorization from Owner                                          ___       ___
                     OR Applicant is Owner                                                       ___       ___
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9.                   Completed Tree Removal Permit Application
                     OR Signed Exemption Form OR Noted as will
                     apply 10 days prior to preliminary plat release                       ___       ___


10.                  Completed Land Clearing Permit Application
                     OR Signed Exemption Form OR Noted as will
                     apply 10 days prior to preliminary plat release                       ___       ___

11.                  Two (2) copies of an environmental survey if all or a
                     portion of the project is in a environmentally sensitive area         ___       ___

12.                  Response from Pre-Application (comment by comment)                    ___       ___

13.                  Written statement and photograph of posted sign                       ___       ___



Application Reviewer:______________________________________________

Application Complete:_____/_____/_____

Scheduled TRC Date: _____/_____/_____

Reviewing Planner:             ______________________________________________




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