Application #:
Name of Subdivision and Name of Owner: Phone:
Address:
The following specific questions relating to this subdivision should be answered and this form included with the presentation of the plat:
Total number of acres in proposed subdivision: Total number of lots anticipated:
Will new streets be created?: How wide?:
Will any additional right-of-way be dedicated along existing streets?
How wide?: Name of Road:
The subdivision will be served by (check one):
Individual wells: Public Water Supply: Other (Specify):
The sanitary need will be served by (check one):
Septic Tanks: Public Sanitary Sewerage System: Other (Specify):
What type of storm drainage will be used?:
Is any land other than streets to be dedicated for public use?:
Describe:
Will any natural drainage course be affected by the subdivision?:
Describe:
Is the property subject to the 100-year flood?:
What is the present use of the land?:
What is zoning classification?:
Any proposed changes in zoning classification?:
Questionnaire prepared by: Date:
(Ord. 2317, passed 12-21-2006)