Fillable APPLICATION FOR SUBDIVISIONS / SITE CONDOMINIUMS AND LAND (Kent County, Michigan)

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APPLICATION FOR SUBDIVISIONS / SITE CONDOMINIUMS AND LAND (Kent County, Michigan)

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Kent County Health Department
Environmental Health Division
700 Fuller Ave NE
Grand Rapids, MI 49503
Phone: (616) 632-6900 Fax: (616) 632-6892
Email: kcehmail@kentcountymi.gov
Website: www.accesskent.com
APPLICATION FOR SUBDIVISIONS / SITE CONDOMINIUMS AND LAND DIVISION EVALUATION
Refer to ENGINEER’S & SURVEYOR’S GUIDE FOR SUBMITTAL OF A PRELIMINARY PLAT or SITE CONDOMINUM
Please check all that apply:
Name of Proposed Development:
Address of Property: City: Zip:
Permanent Parcel #:4 1 - - - - Township:
Intended Use:
☐ Single Family ☐ Two Family ☐ Multiple Family ☐ Commercial ☐ Industrial
General Site Information:
☐ Distance to nearest existing public water system:
☐ Distance to nearest public sewer system:
☐ Has there been a previous soil evaluation done on this property? If yes, indicate date of evaluation:
☐ Are there any utility easements through this property?
If yes, indicate what type
(included location on site plan)
:
☐ Are there any existing buildings, drainfields or wells on this property?
If yes, please explain
(include location on site plan)
:
☐ Are there any known environmental concerns associated
with this site? e.g. 201 site, LUST site, PEAS report, BEA report etc.:
If different from above, provide Name & Phone # for access to property:
I hereby apply for the above requested service(s) and have enclosed the applicable fee(s). I agree to remit additional fees as may be necessary. I
understand that the proposed development will be reviewed in accordance with the Administrative Rules for Onsite Water Supply and Sewage Disposal for
Land Divisions and Subdivisions (R560.401 to R560.428). The service of a backhoe/power auger or greater is necessary for evaluation
of the soil. The
developer or engineering firm is responsible for coordinating and providing the backhoe/power auger service. Failure to show up for an appointment may
result in a $75 charge. Application fees are non-refundable upon initiation of any field activities. A $50 processing fee applies to all applications
cancelled prior to field work.
Applicant’s Signature: Date:
FOR OFFICE USE ONLY
Required Fees: X = $
Number of Lots Fee per Lot Total Fee
Receipt #: Date:
☐ Subdivision
☐ Site Condominium ☐ Land Division
Septic
-
$80.00 per Lot
$100.00 per Lot
Well
-
$60.00 per Lot
Septic and Well
-
$120.00 per Lot
Septic
Well
☐ On-Site ☐ On-Site
☐ Municipal ☐ Municipal
☐ On-Site Community Septic
Number of Acres:
Number of Lots:
Minimum Lot Area:
Applicant
:
Address:
City: State: Zip:
Phone:
Fax:
Email:
Pick One:
☐
☐☐
☐
Email Results to Email Address provided
☐
☐☐
☐
Call my phone # to pick up results
☐
☐☐
☐
Other:
x
Kent County Health Department
Environmental Health Division
700 Fuller Ave NE
Grand Rapids, MI 49503
Phone: (616) 632-6900 Fax: (616) 632-6892
Email: kcehmail@kentcountymi.gov
Website: www.accesskent.com
Instructions:
• Application must be Signed and Dated.
• Submit Application with Payment to:
Kent County Health Department
Environmental Health
700 Fuller Ave. NE
Grand Rapids, MI 49503
• We accept Cash, Check, Money Order, Visa, MasterCard, and Discover. If paying by Check or Money Order, make it out to Kent County
Environmental Health. If paying by Credit Card, please call our office at 616-632-6900 to make payment over the phone.
• Application will not be processed unless completed, signed and submitted with required fee.
• Upon receipt of a complete application and payment, we will contact you to schedule an appointment.
ENGINEER’S and SURVEYOR’S REQUIREMENTS for SUBMITTAL of a
PRELIMINARY PLAT or SITE CONDOMINIUM
The Subdivision and Site Condominium Site Report, preliminary plat/condo drawings and all supporting documentation must be submitted in
triplicate with the applicable fees. To obtain Michigan Department of Environmental Quality (MDEQ) information, rules, and forms, please visit
www.michigan.gov/deq. Proposals will be reviewed in accordance with the Administrative Rules for On-site Water Supply and Sewage Disposal for
Land Divisions and Subdivisions (R560.401 to R560.428).
Submittals for preliminary plat or condominium review must be accompanied by items 1-5
1. A properly completed KCHD SUBDIVISION/SITE CONDO AND LAND DIVISION EVALUATION APPLICATION
2. All applicable fees
3. A completed Site
Report
4. Preliminary plat drawing shall show or include the following:
• Contours
Existing and proposed 5 foot contours, OR
Detailed plans with maximum 2 foot contours are required where less than one acre lots/units are proposed, where slopes exceed
12%, where groundwater is present within 6 feet of the surface and/or extensive site modifications are proposed.
• Cutting and Filling
Proposed extensive cutting and filling
must be shown on the plan and type of fill to be used.
• Physical Features – Existing or Proposed
River, stream, creek, lake, county drain, subsurface drain, lagoon, slip, waterway, bay canal &/or artificial impoundments; established
100 year floodplain area and elevation; normal high water level for waterfront property, wetlands
• Existing Facilities and Structures
Buildings, sewage systems, high tension lines, utility easements, excavations, bridges, culverts, wells, water wells (including
proposed/existing test wells), soil borings, underground storage tanks, drainage easements
• Building Setback Lines
Roads, waterfront, lot/unit lines, limi
ted and common elements
5. Supporting data regarding water supply and/or sewage disposal suitability.
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APPLICATION FOR SUBDIVISIONS SITE CONDOMINIUMS AND LAND (Kent County, Michigan)

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Completed 29 July 2020

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