Application #
PLAT QUESTIONNAIRE
Name of Subdivision ________________________________________________
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 needs 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 one hundred year flood? ________________________
What is the present use of the land? ______________________________________
What is zoning classification? ______________
Any proposed changes in zoning classification? _________________
Questionnaire prepared by ____________________________________________
(Ord. 12-94, § 305, passed 1-17-95)