MADISON COUN TY
APPLICATION FOR WATERSHED SPECIAL INTENSITY ALLOCATION
Date: __________ Fee:_________________ Application #:_______________________
Base $500 + 100/acre
Property Owner(s):____________________________________________________________________________
Mailing Address:______________________________________________________________________________
Daytime Phone:___________________ E-Mail Address:____________________________________________
Applicant:____________________________________________________________________________________
Mailing Address:______________________________________________________________________________
Daytime Phone: _________________ E-Mail Address:______________________________________________
PROPERTY INFORMATION
Property Location:_____________________________________________________________________________
Parcel Identification #: _________________________________________________________________________
Deed Book:_________ Page #:_________ Zoning District:__________________________________
Watershed Name: ___________________ Watershed Class:__________ Basin Name:____________________
PROJECT INFROMATION
Name of Project:_______________________________________________________________________________
General Description of Work:___________________________________________________________________
_____________________________________________________________________________________________
Project Timeline (Must be started in one (1) year or less): ____________________________________________
Total Area of Property: _______________Square Feet ______________________________________Acres
Is Property Vacant: ___________ 70% of Tract = _________________________________ Square Feet
Are any perennial streams located on or adjacent to the site? _________________________________________
Amount of Built-Upon Amount of Built-Upon
Area (Square Feet) Area (Square Feet)
Existing Built Buildings
Upon Area on Pavement (Asphalt/Gravel)
Site Other BUA
Proposed Built- Buildings
Upon Area Pavement (Asphalt/Gravel)
Other BUA
Additional Information Required
*A site plan prepared by a professional registered engineer or land surveyor (see attached sheet).
*Consistent with Redbook rules.
* You shall notify the zoning officer of any modifications to this property.
The undersigned property owner(s) or contract purchaser(s) hereby authorize(s) the filing of this application
and authorize(s) on-site review and periodic inspections by authorized municipal/county Staff.
Signature:____________________________________ Date:_____________________________________
The undersigned applicant hereby certifies that, to the best of his or her knowledge and belief, all information
supplied with this application is true and accurate.
Signature:___________________________________ Date:_____________________________________
click to sign
signature
click to edit
![]()
click to sign
signature
click to edit
![]()
