COUNTY SUBDIVISION REGULATIONS

APPLICATION FOR PRELIMINARY PLAT APPROVAL

INSTRUCTIONS:

Print or type clearly. Use additional sheets if necessary. All required attachments and support documentation shall be submitted with this application form. Incomplete or inaccurate applications may delay public hearing or decision dates. The completed application package must be submitted to the Subdivision Review Officer by the subdivider or a designated agent and shall comply with the requirements of the County Subdivision Regulations. Each application must be accompanied by the required administrative fee.

APPLICANT

1. Subdivider Name, Address, and Phone Number:

_________________________________________________

_________________________________________________

________________________________________________

Date

Signature

2. Agent (if any) Name, Address, and Phone Number:

_________________________________________________

_________________________________________________

_________________________________________________

Date

Signature

3. Engineer Name, Address, and Phone Number:

_________________________________________________

_________________________________________________

_________________________________________________

Date

Signature

4. Surveyor Name, Address, and Phone Number:

_________________________________________________

________________________________________________

_________________________________________________

Date

Signature

SUBDIVISION INFORMATION

5. Name of Subdivision

6. Indicate if this is a succeeding subdivision, phased subdivision, or resubdivision:

_______________________________________________________________________

7. Is this is a Type One Two Three Four Subdivision? (check one)

8. Number of lots: Total acreage:

Size of smallest lot: Acres

9. Municipal planning and platting jurisdiction (if applicable):

SUPPLEMENTAL INFORMATION

10. If this is a succeeding subdivision, provide detailed attachments indicating the relationship between the proposed subdivisions and the previous subdivision.

11. If this is part of a phased subdivision, attach a master plan of all phases indicating the current proposed phase and an anticipated phasing schedule.

12. If this is a resubdivision, provide a reference to the original plat with an explanation of the proposed changes.

13. Supporting documentation required for the preliminary plat review as defined by the County Subdivision Regulations shall be attached to this application.

14. The required number of copies of the preliminary plat map as specified by the County Subdivision Regulations shall be attached to this application.

15. A draft copy of the disclosure statement shall be attached to this application and shall be in accordance with the standardized format provided in the County Subdivision Regulations.

PROCEDURAL INFORMATION (to be completed by County Staff)

16. Date application received by County Initial

17. Date preliminary plat deemed complete Initial

18. Date of public hearing