Fillable Minor Preliminary Plat Application (Polk County)

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Minor Preliminary Plat Application (Polk County)

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(
time stamp)
Official Use Only
Minor Preliminary Plat Application
A subdivision plat for not more than four lots within a tract of record.
The Minor Preliminary Plat will be reviewed and approved upon satisfactory
compliance with the Comprehensive Plan, Zoning Ordinance and pertinent Subdivision
Ordinance regulations.
P
lease complete the entire application and submit with the required documentation
and fee.
1. A
pplicant Information
Applicant (Print Name) Phone
I
nterest in Property (owner, renter, perspective buyer, etc.)
A
ddress, City, State and Zip
E
mail
2. Developer Information
D
eveloper (Print Name) Phone Email
A
ddress, City, State and Zip
3. P
roperty Owner Information
P
roperty Owner (Print Name) Phone Email
A
ddress, City, State and Zip
4. S
ubject Property Information
P
roperty Address Zoning District
D
istrict and Parcel Number
Legal Description:
P
roject Description:
5. Filing Fee: $268 + $15 per lot (not including outlots)
6. Attached Checklist and Subdivision Plat Notes
2
Minor Preliminary Plat
N
o public streets are proposed
Not more than 4 lots within a tract of record (¼, ¼ Section)
No waivers requested
Submittal Requirements:
3 copies of the Preliminary Plat + Electronic Copy
Application Form
Application Fee - $268.00 + $15 per lot, not including outlots
Process:
Intake
•S
ubmit completed application, Preliminary Plat and fee
•Polk County contacts jurisdiction if within 2 miles
Review
•10 working day review time by Polk County staff
•E-mail comments to Applicant and Property Owne
r
Admin.
Approval
•2
copies of the approved Preliminary Plat are stamped and retained by
Polk County
•Approval e-mail is sent to Applicant and to Property Owner
3
Minor Preliminary Plat Checklist
Information Required
M
ap scale 1’=50’ or 1”=60’ or 1”=100’ if necessary
P
lan size shall not exceed 24” X 36” *may be drawn on more than one sheet with appropriate match lines
N
ame of Development
T
ype of map or plat (preliminary, final, plat of survey)
L
ocation of map or plat (address, city, township, section & range)
L
egal Description of parcel and source of boundary information (plat book &page) and number acres
N
orth arrow and scale
O
wner’s and/or Developer’s name, address, telephone number
S
urveyor’s name, address, telephone number
R
egistration and seal of surveyor
D
ate(s) prepared and revision dates
L
ocation and names of adjoining subdivisions
N
ames of owners of all adjoining parcels
I
dentify adjacent parcels and their boundaries
Z
oning classification
B
oundaries of parcel to be subdivided in heavy line (phase lines, if multiple phases)
Fr
ont building setback lines
Vi
cinity sketch at a scale of 1 inch equals 2000 feet
P
roposed 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
L
ocation 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 land uses including structures and setbacks
E
xisting 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
L
ocation of masses of trees, and isolated trees with diameter greater than 16 inches
Location, dimension and size of permanent runoff control structures
S
ource of water, source of sewage disposal and location of proposed service pipes
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
L
ocation, dimensions and size of areas proposed for public dedication and use
4
Please add the following notes as applicable:
• Mailb
oxes 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.
• 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.
• Post development runoff will not adversely affect downstream drainage facilities or property owners.
• Due to soil types, limitations, and disturbance, alternative septic systems may be required. Individual
wastewater treatment systems shall be designed by an Engineer.
• Any access restriction may be revised or removed by the Polk County Public Works Department.
• Note utility service providers.
Polk County Public Works, Planning & Development Division
5885 NE 14
th
Street, Des Moines, IA 50313
▪ Forms available online http://www.polkcountyiowa.gov/PublicWorks/
Phone: (515)286-3705
Email: PublicWork
s@polkcountyiowa.gov
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Minor Preliminary Plat Application (Polk County)

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Completed 14 February 2021

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