(t
ime stamp)
Official Use Only
Major Preliminary Plat Application
A s
ubdivision plat for five or more lots within a tract of record.
The Major Preliminary Plat will be reviewed and approved upon satisfactory
compliance with the Comprehensive Plan, Zoning Ordinance and pertinent Subdivision
Ordinance regulations.
Pl
ease complete the entire application and submit with the required documentation
and fee.
1. Appl
icant Information
Applicant (Print Name) Phone
Interest in Property (owner, renter, perspective buyer, etc.)
Addr
ess, City, State and Zip
Em
ail
2. De
veloper Information
Dev
eloper (Print Name) Phone Email
Address, City, State and Zip
3. Pr
operty Owner Information
Property Owner (Print Name) Phone Email
Addr
ess, City, State and Zip
4. Subj
ect Property Information
Pr
operty Address Zoning District
Di
strict and Parcel Number
Legal
Description:
Pr
oject Description:
Wai
ver Description:
5. Filing Fee: $403 + $15 per lot (not including outlots) with a public street or $268 + $15 per lot (not including
outlots) without a public street.
6. Attached Checklist and Subdivision Plat Notes
7. Attached Density Calculation Worksheet
2
Major Preliminary Plat
5 or mor
e lots within a tract of record (¼, ¼ Section).
Waivers are requested.
Submittal Requirements:
3 copies of the Preliminary Plat + Electronic
Copy
Completed Application Form and Density
Worksheet
Application Fee - $403 + $15 per lot, not including outlots (with a public street) or $268 + $15 per lot,
not including outlots (without a public street)
Process:
Intake
Sub
mittal (Plat, Application, Density Worksheet & Fee)
Polk County contacts jurisdiction if within 2 miles
Review
10 business day review time by Polk County staff
Comments e-mailed to Applicant and Property Owner
Zoning
Commission
Zon
ing Commission review and recommendation
Resolve remaining comments with Polk County staff
Board
of
Supervisors
Polk
County Board of Supervisor's meeting - Final Decision
3
Major Preliminary Plat
Information Required
Map scale 1’=50’ or 1”=60’ or 1”=100’
Plan size shall not exceed 24” X 36”
* may be drawn on more than one sheet with appropriate match lines
Name of Development
Type of plat (preliminary)
Location of map or plat (address, city, township, section & range)
Legal Description of parcel and source of boundary information (plat book & page) and number acres
North arrow and scale
Owner’s and/or Developer’s name, address, telephone number
Surveyor’s name, address, telephone number
Registration and seal of surveyor
Date(s) prepared and revision dates
Boundary lines of subdivided area with accurate distances, bearings and boundary angles
Location and names of adjoining subdivisions
Names of owners of all adjoining parcels
Identify adjacent parcels and their boundaries
Zoning classification
Boundaries of parcel to be subdivided in heavy line (phase lines, if multiple phases)
Front building setback lines
Vicinity sketch at a scale of 1 inch equals 2000 feet
Proposed lot lines, lot numbers, dimensions, and lot area (in square feet, if below 1 acre)
Existing and proposed topography (USGS datum) showing contour intervals of at least five (5) feet and at
least two contour elevations given in MSL
Location of natural, historical and archeological resources
Location, names and widths of all existing and proposed alleys, streets and highways adjacent or on the
parcel or adjoining parcels including pavement widths
Existing and proposed right of way widths and centerlines
Existing land uses including structures and setbacks
Existing railroads, above and underground utilities and utility poles
Location and areas of drainageways, streams, lakes and ponds, marshes, swamps and wetlands, and
proposed storm sewers
Location, area and elevations of floodway and flood fringe from Flood Hazard Boundary Maps
Location of masses of trees, and isolated trees with diameter greater than 16 inches
Location, dimension and size of permanent runoff control structures
Source of water, source of sewage disposal, and location of proposed service pipes
Location and sizes of proposed and existing water, sanitary sewer, and storm sewer lines
Location, width and type of easements for public utilities: sanitary sewer, water, storm sewer, gas, electric,
cable TV
Location, dimensions and size of common areas and open space areas under Owner Association control
Location, dimensions and size of areas proposed for public dedication and use
Submit completed Density Calculations for subdivision
4
Major Preliminary Plat
Please add the following notes as applicable:
Mailboxes within the road right-of-way shall be of a breakaway design.
The existing buildings noted to be removed shall be done so prior to final plat approval.
Access to [insert state highway name here] must be approved by the Iowa Department of Transportation.
Future development of the property is subject to Article 7, Section 4, "Natural Resource Protection,
Woodlands" of the Polk County Zoning Code, which preserves wooded areas of the property.
Any subsurface drainage facilities that are disturbed must be restored or rerouted by the property owner.
Services to all utilities located on the opposite side of the roadway must be bored under the roadway at the
lot owner's expense.
Maintenance of all drainage easements to be the responsibility of the property owner.
Culverts to be used for crossing drainage easements must be designed by a licensed professional
engineer.
[Insert County road Street Lot Letter Here] shall be dedicated to Polk County for roadway purposes. [Insert
County road Street Lot Letter Here] shall be dedicated to Polk County for roadway purposes at such time
the roadway has been improved and accepted into the Polk County Secondary Road System by the Polk
County Board of Supervisors.
Post development runoff will not adversely affect downstream drainage facilities or property owners.
It shall be the Developer's responsibility to apply for and obtain any storm water discharge permits from the
Iowa Department of Natural Resources.
The Developer shall be responsible for the maintenance of the pavement on the temporary turnaround until
the next phase of the development.
Polk County does not require or issue permits for sidewalks and does not accept the liability and/or
responsibility for construction placement, repair, or maintenance thereof of any street sidewalk installed in
the plat by any home owner.
Due to soil types, limitations, and disturbance, alternative septic systems may be required. Individual
wastewater treatment systems shall be designed by an Engineer.
Grading contractor will be required to provide a 4-year maintenance bond for erosion control. The IDNR
Storm Water Discharge Permit will be required prior to grading operations.
The Homeowner's Association will be responsible for the maintenance and repair of the detention basins
and detention outlet facilities.
Note utility service providers.
Access to each lot is restricted to the subdivision road. [Plats with proposed internal streets]
Polk County Public Works, Planning & Development Division
5885 NE 14
th
Street, Des Moines, IA 50313
Phone (515) 286-3705
email: PublicWorks@polkcountyiowa.gov
Forms available online http://www.polkcountyiowa.gov/PublicWorks/
5
Residential Development Calculation Worksheet
Project Name
Zoning District
Development Option
A.
Base Site Area Calculation
acres
less right of way, different development option, different zoning
acres
Equals base site area
(a)
acres
B.
Natural Resources Calculations
multiply minimum protection % (1) and acres in resource (2) to obtain protection required (3)
(1)
(2)
(3)
Resource Natural Feature
Minimum
Protection %
Acres in
Resource
Resource
Protection
Floodplains -Floodway
100%
acres
Floodplains -Floodway Fringe
75%
acres
Drainageway
75%
acres
Woodlands - Mature
75%
acres
Woodlands -Young
50%
acres
Native Prairie
100%
acres
Wetlands
100%
acres
add calculated resource protection for each feature in column (3) to obtain total
* If resources overlap on the same area of land, only the most restrictive shall be used.
** Where mitigation allowed, disturbed area not counted but on site relocation area is
acres
C.
Minimum District Required Open Space Calculation
multiply times base site area
(a)
acres
Required Open Space
acres
D.
Net Buildable Site Area Calculation
Subtract acres in Resource Protection or Required Open Space (whichever is greater)
from base site area
(a)
acres
Net Buildable Site Area
acres
E.
multiply times net buildable site area
acres
lots
F.
multiply times base site area
(a)
acres
District Maximum Density Yield (round down)
lots
G.
Maximum Lots permitted for Site
Site Maximum Density Yield or District Maximum Density Yield (whichever is lower)
lots
6
Non- Residential Development Calculation Worksheet
Project Name
Zoning District
Development Type
NAICS Code
A.
Base Site Area Calculation
Development site area as determined by actual land survey.
acres
less right of way, different development option, different zoning
acres
Equals base site area
(a)
acres
B.
Natural Resources Calculations
multiply minimum protection % (1) and acres in resource (2) to obtain protection required (3)
(1)
(2)
(3)
Resource Natural Feature
Minimum
Protection %
Acres in
Resource
Resource
Protection
Floodplains -Floodway
100%
acres
Floodplains -Floodway Fringe
75%
acres
Drainageway
75%
acres
Woodlands - Mature
75%
acres
Woodlands -Young
50%
acres
Native Prairie
100%
acres
Wetlands
100%
acres
add calculated resource protection for each feature in column (3) to obtain total
* If resources overlap on the same area of land, only the most restrictive shall be used.
** Where mitigation allowed, disturbed area not counted but on site relocation area is
Total Acres in Resource Protection
acres
C.
Minimum District Required Open Space Ratio Calculation
Development option minimum open space ratio (see table)
multiply times base site area
(a)
acres
Minimum District Open Space
acres
D.
Required Open Space
Take Resource Protection or Minimum Open Space (whichever is greater) equals amount of base
site
required to be in open space and/or resource protection
sq ft
E.
Maximum Floor Area Ratio
Take Maximum Floor Area Ratio (see table)
multiply times base site area
(a)
acres
Maximum Floor Area allowed
sq ft
Summary
Base Site
ac/sq ft
Open Space Required
sf
Maximum Floor Area allowed
sf