/Subdivision/MINORSUB
2020-03-24
CITY OF ST. MARYS
ELK COUNTY, PENNSYLVANIA
SUBDIVISION AND LAND DEVELOPMENT ORDINANCE
APPLICATION FOR MINOR SUBDIVISION PLAN APPROVAL
APPLICATION OF:
_____________________________________ _________________________________________
NAME ADDRESS
_____________________________________ _________________________________________
TELEPHONE CITY, STATE, ZIP
NAME OF SUBDIVISION ___________________________________________________________
APPLICANT’S INTEREST______________________________________________________________
OWNER NAME ______________________________________________________________________
DEED REFERENCE _________________________ TAX MAP #_____________________________
ENGINEER NAME AND ADDRESS ____________________________________________________
CONTACT NAME AND PHONE NUMBER _____________________________________________
PROPERTY
LOCATION________________________________________________ROAD/STREET
SIZE BEFORE DIVISION ____________________ ACRES OR ___________________SQ. FT.
NUMBER OF LOTS___________________ SIZE OF LOTS _______________________________
PROPOSED USE______________________________________________________________________
UTILITIES:
ON SITE SEPTIC SYSTEM WELL/SPRING
EXTENSION OF CITY SANITARY SEWER CITY WATER
GAS ELECTRIC TELEPHONE
ROAD/STREET: (if applicable) PUBLIC PRIVATE
APPLICANT MUST COMPLY WITH CHECK LIST PROVIDED WITH APPLICATION.
The undersigned hereby represents that, to the best of my knowledge and belief, all information listed
above is true and complete
.
SIGNATURE OF APPLICANT
__________________________________________________ DATE __________________________
Application # ___________________
Dat
e Received __________________
Zo
ning District _________________
Fee $25.00 per lot _______________
($10 County Fee)
(814) 834-1304 (FAX)
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