Date:
Name :
Phone,
Address:
City:
State:
Zip Code:
Is Mailing address different from above:
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.)
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:
Existing utility main lines currently serving subdivision property:
Proposed utility main line extensions to serve subdivision property:
Proposed number of new utility service connections within subdivision property:
Existing street(s) serving subdivision property:
Are new streets/alleys or street/alley extensions proposed to serve subdivision?
Explain:
Is Variance/exception/waiver requested (Separate application required):
Development/subdivision improvements agreement required/requested:
Are property owners different form Applicant:
Owner 1
Name:
Phone:
Owner 2
Owner 3
Applicant(s):
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