12-14-1: GENERAL DESCRIPTION AND INFORMATION:
   GENERAL DESCRIPTION AND INFORMATION
1.   Name of the proposed subdivision    
2.   Location (City and/or County)    
Legal description:     1/4     1/4 of Section       Township       Range      
3.   Type of water supply system:
a.   Individual surface water supply from spring         
b.   Multiple-family water supply system (3-14 connections and fewer than 25 people)         
c.   Service connection to multiple-family system         
d.   Service connection to public system         
e.   Extension of public main         
f.   New public system         
g.   Individual well         
4.   Type of wastewater treatment system:
a.   Individual or shared on site septic system         
b.   Multiple-family on site system (3-14 connections and fewer than 25 people)         
c.   Service connection to multiple-family system         
d.   Service connection to public system         
e.   Extension of public main         
f.   New public system         
5.   Name of solid waste garbage disposal site and hauler:
6.   Is information included which substantiates that there will be no degradation of state waters or that degradation will be nonsignificant?
7.   Descriptive Data:
a.   Number of lots or rental spaces    
b.   Total acreage in lots being reviewed    
c.   Total acreage in streets or roads    
d.   Total acreage in parks, open space, and/or common facilities    
e.   TOTAL gross acreage of subdivision    
f.   Minimum size of lots or spaces    
g.   Maximum size of lots or spaces    
8.   Indicate the proposed use(s) and number of lots or spaces in each:
   Residential, single-family
   Residential, multiple-family
   Types of multiple-family structures and numbers of each (e.g., duplex)
   Planned unit development (Number of units      )
   Condominium (Number of units      )
   Mobile Home Subdivision (Number of spaces      )
   Recreational vehicle subdivision (Number of spaces      )
   Commercial or industrial
   Other (please describe)    
9.   Provide the following information regarding the development:
a.   Current land use    
b.   Existing zoning or other regulations    
c.   Depth to ground water at the time of year when water table is nearest to the natural ground surface within the drainfield area    
d.   Depth to bedrock or other impervious material in the drainfield area    
e.   If a tract of land is to be subdivided in phases, an overall development plan indicating the intent for the development of the remainder of the tract.
f.   Drafts of any covenants and restrictions to be included in deeds or contracts for sale. Drafts of homeowners' association bylaws and articles of incorporation, if applicable. (Submitting a draft copy of a homeowners' association bylaws and articles of incorporation is adequate for DEQ to initiate and complete its review of sanitary facilities, but a copy of the fully executed documents must be submitted before DEQ can issue final approval.)
g.   Indicate whether the mineral rights have been severed from the property:
Yes       No       Unknown      
h.   Indicate whether water rights have been severed from the property:
Yes       No      
10.   Is the applicant claiming an exemption under section 12-6-2 of the subdivision regulations from the requirement to prepare an environmental assessment?
Yes       No      
Name, address, and telephone number of designated representative, if any (e.g., engineer, surveyor):
Name
Phone
Address (Street or PO Box, City, State, Zip Code)
Name, address, and telephone number of owner(s):
Name
Signature of owner
Address (Street or PO Box, City, State, Zip Code)
Phone
Date
Name, address, and telephone number of subdivider if different than owner(s):
Name
Signature of subdivider
Address (Street or PO Box, City, State, Zip Code)
Phone
Date
The application must be signed by the owner of the land proposed for subdivision or the responsible officer of the corporation offering the same for sale.
(Ord. 784, 8-6-2007)