Application is hereby made for the review of
the subdivision of land described below:
Plan
Name ____________________________ County Index ______________________
Exact
Location ___________________________________________________________
Fee
$________ Date Received ________________ Received By ___________________
Note:
If sewer is not available, Sewage Planning Modules from DEP must be completed.
Address
________________________________________________________________
Name
of Landowner ______________________________________________________
Address
________________________________________________________________
Name
of Engineer or Surveyor ______________________________________________
Address
________________________________________________________________
Total
acreage in plan __________ Average lot size _______ Average lot frontage ______
Does this plan require a change in zoning classification? __________________________
If yes,
has an application for rezoning been filed? _______________________________
I hereby depose and say that all of the above statements contained in this application and supporting documents herewith are true. Signature ______________________________
Date __________________________________
Office Use Only
Engineers
Review ________________________________________________________
Board of Supervisors Action ________________________________________________