APPENDIX B: PLAT QUESTIONNAIRE

   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)