Appendix II
APPLICATION FOR
APPROVAL OF PRELIMINARY PLAT
CITY OF NEWARK
LICKING COUNTY, OHIO
Date:                
1.    Name of Applicant                      
   Address                         
   Telephone                         
2.    Name of Surveyor                      
   Address                         
   Telephone                         
3.    Engineer                         
   Address                         
   Telephone                         
4.    Name of Subdivision                       
5.    Present Zoning District                      
6.    School District                         
   Name of Schools Serving the Subdivision Area             
   High School                         
   Junior High or Middle School                   
   Elementary School                      
7.    Proposed Subdivision Will be Serviced by:
   Newark Water          Yes         No       
   Newark Sanitary Sewer       Yes        No       
   Ohio Power Co.          Yes        No       
   Licking Rural Electrification       Yes        No       
   Alltel Telephone          Yes        No       
   Cable Television - Company Name:                
8.    Proposed Subdivision:
      Total Acres                      
      Total Acres in Lots                   
      Total Acres in Roadway                
      Total Acres Other Than Lots or Roadways          
9.    Proposed Escrow Agent (Per Section 1222.03)          
10.    Proposed Deed Covenants or
   Restrictions Submitted          Yes         No       
11.    Six Sets of Drawings (prints)
   Submitted             Yes         No       
12.    Fee of $              Paid          Yes         No       
13.    Legal Description of Boundary of Proposed
   Subdivision Submitted          Yes         No       
                              
Applicant's Signature             Surveyor or Engineer's Signature
   Date Received:                      
   Date of Meeting to be Considered at:                
   Action by Planning Commission:                
                              
   Date                      Signature
(Ord. 93-62. Passed 10-3-94.)