DELAWARE COUNTY PLANNING COMMISSION
APPLICATION FOR ACT 247 REVIEW
Incomplete applications will be returned and will not be considered “received” until
all required information is provided.
Please type or print legibly
DEVELOPER/APPLICANT
Name___________________________________ E-mail ______________________________________
Address____________________________________________________ Phone____________________
Name of Development____________________________________________________________________
Municipality____________________________________________________________________________
ARCHITECT, ENGINEER, OR SURVEYOR
Name of Firm____________________________________ Phone_________________________________
Address_______________________________________________________________________________
Contact___________________________________ E-mail______________________________________
Utilities
Type of Review
Plan Status Existin
g
Proposed Environmental
Characteristics
ٱ Zoning Change
ٱ Sketch ٱ Public Sewerage ٱ Public Sewerage
ٱ Land Development
ٱ Preliminary ٱ Private Sewerage ٱ Private Sewerage ٱ Wetlands
ٱ Subdivision
ٱ Final ٱ Public Water ٱ Public Water ٱ Floodplain
ٱ PRD
ٱ Tentative ٱ Private Water ٱ Private Water ٱ Steep Slopes
Zoning District______________________________ Tax Map # _ _/ _ _/ _ _ _
Tax Folio # _ _/ _ _/ _ _ _ _ _ / _ _
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STATEMENT OF INTENT
WRITING “SEE ATTACHED PLAN” IS NOT ACCEPTABLE.
Existing and/or Proposed Use of Site/Buildings:
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
Total Site Area ___________________ Acres
Size of All Existing Buildings ___________________ Square Feet
Size of All Proposed Buildings ____________________ Square Feet
Size of Buildings to be Demolished ____________________ Square Feet
____________________________________ ____________________________________
Print Developer’s Name Developer’s Signature
MUNICIPAL SECTION
ALL APPLICATIONS AND THEIR CONTENT ARE A MUNICIPAL RESPONSIBILITY.
Local Planning Commission Regular Meeting__________________________________
Local Governing Body Regular Meeting___________________________________
Municipal request for DCPD staff comments prior to DCPC meeting, to meet municipal meeting date:
Actual Date Needed _________________________________________________________________
IMPORTANT: If previously submitted, show assigned DCPD File # ______________________
_______________________________________________ ________________________
Print Name and Title of Designated Municipal Official Phone Number
_______________________________________________ ________________________
Official’s Signature Date
FOR DCPD USE ONLY
Review Fee: Check #__________ Amount $__________ Date Received__________
Applications with original signatures must be submitted to DCPD.
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