Boundary County Planning & Zoning

APPLICATION

Subdivision ~ Short Plat

SUB   SP       

Date: _________________

                 Name:  ______________________________________

            Address:  ______________________________________

City, State, Zip:  ______________________________________

        Telephone:  ______________________________________

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

Owner's Name: _______________________________       Owner's telephone _________________________

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

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 of ownership; legal descriptions or record of survey for each parcel proposed, showing accurate parcel size, and fee established at Chapter 17, Boundary County Zoning and Subdivision Ordinance.

_____________________________________  ___________                   ___________________________________________

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