Boundary County Planning & Zoning

APPLICATION

Subdivisions and Short Plats

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)

  If this is a pre-application review, include a site plan showing sufficient detail to depict nature and scope of proposal.  For all other applications, include three copies of the preliminary plat.

_____________________________________  ___________                   ______________________________________________

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

Form #29E - 11/99