Boundary County Planning & Zoning

APPLICATION

Subdivision ~ Long Plat

SUB   LP       

Date: _________________

                 Name:  ______________________________________

            Address:  ______________________________________

City, State, Zip:  ______________________________________

        Telephone:  ______________________________________

Are you the owner of the property?  ___ Yes  ___ No  If not, owner's address ___________________________

       Owner's telephone _________________________

Parcel Number: _____________________  Size Parcel:  __________  Zone District:  ___________________

Subdivision Name: _______________________________________Number of lots proposed:  _____________

Description of proposal, including actions to mitigate impact to surrounding parcels (use additional sheets if necessary)

  Include with application the following: Deed(s) of ownership; preliminary plat showing roads, road names, utility easements, lot configuration and size, and a vicinity map showing general area in which subdivision is proposed. If the applicant is not the owner of the parcel(s) proposed for subdivision, also include a written statement from the owner(s) authorizing submission of the application; fee as established at Chapter 17.

_____________________________________  ___________                   ___________________________________________

Applicant's signature                                       Date                                 Owner's signature (if different than applicant)