Application For Major Subdivision Sketch Pan Page 1 Applicant Date: OwnerAgent Name : Phone, Address: City: State: Please select...ALAKAZARCACOCTDEDCFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWY Zip Code: Is Mailing address different from above: YesNo Address: City: State: Please select...ALAKAZARCACOCTDEDCFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWY Zip Code: Property Subject to Application Address: City: State: Please select...ALAKAZARCACOCTDEDCFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWY Zip Code: Practical Property Description: Legal Description: Attach Additional Information: Proposed Subdivision/Project Name: Brief description of subdivision proposal - include number of proposed lots and land use(s), (e.g., residential, commercial, etc.) Attach Additional Information: Proposed Number of Lots and Type of Units: Acreage or Square Feet of Parcel: Existing Zoning: Surrounding Zoning North: West: South: East: Present Use of Subject Property: Uses Surrounding Subject Parcel North: West: South: East: Page 2 Utility Information Existing utility main lines currently serving subdivision property: Water Electric Sewer Gas Proposed utility main line extensions to serve subdivision property: Water Electric Sewer Gas Proposed number of new utility service connections within subdivision property: Water Electric Sewer Gas Street Information Existing street(s) serving subdivision property: Are new streets/alleys or street/alley extensions proposed to serve subdivision? YesNo Explain: Miscellaneous Is Variance/exception/waiver requested (Separate application required): YesNo Development/subdivision improvements agreement required/requested: YesNo Are property owners different form Applicant: YesNo Owner 1 Name: Phone: Address: City: State: Please select...ALAKAZARCACOCTDEDCFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWY Zip Code: Owner 2 Name: Phone: Address: City: State: Please select...ALAKAZARCACOCTDEDCFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWY Zip Code: Owner 3 Name: Phone: Address: City: State: Please select...ALAKAZARCACOCTDEDCFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWY Zip Code: Authorization NOTE: , In the event the town must retain outside professional services to process or evaluate an application, the applicant shall bear the costs of same, inclusive of land planning, engineering and legal fees, in addition to the base application fee. , A deposit to cover the reasonable anticipated costs for outside professional services will be required at the time of application. I hereby certify that I am the applicant named above and that the information contained herein and on any attachments hereto is in all respects true and accurate to the best of my knowledge and belief. ,I also acknowledge that I must notify all owners of any severed mineral estates associated with the real property subject to this application in accordance with C.R.S. 24-65.5-103. Applicant(s): Date: Applicant(s): Date: Need assistance with this form?
