Land Use /
Minor
Residential
Subdivision
Application
OFFICIAL USE ONLY:
UDO Number:
Date Filed:
Amount Paid:
Received By:
LLC current:
Zoning Dist.:
Flood Zone:
Watershed (Y/N):
Taxes Pd(Y/N):
Application for 1 Lot Minor Subdivision Plus Residual Lot
Contact Information
PROPERTY OWNER
APPLICANT
AGENT FOR APPLICANT
Name:
Name:
Address:
Address:
Telephone:
Telephone:
Email:
Email:
LEGAL RELATIONSHIP OF APPLICANT TO PROPERTY OWNER:
DOCUMENTATION OF PROPERTY OWNER GIVING CONSENT TO AGENT (Y/N/NA):
Project/Property Information
Physical Street Address
Location:
Parcel ID Number(s):
Deed Book / Page Number and/or Plat Cabinet / Slide Number:
Total Parcel(s) Acreage:
Total Number of Lots:
Existing Land Use of Property
Water Fee Paid (Y,N,NA):
Perc Test (Y,N,NA):
County Approval Sewer Connection (Y,N,NA):
Meeting
Community Meeting Held? (Y,N,NA): Meeting Location:
I, the undersigned, do certify that all of the information presented in this application is accurate to
the best of my knowledge, information, and belief. Further, I hereby authorize county officials to
enter my property during reasonable business hours for purposes of determining zoning compliance.
All information submitted and required as part of this application process shall become public
record.
_____________________________________ ____________________
Property Owner(s)/Applicant* Date
*Note: Forms must be signed by the owner(s) of record, contract purchaser(s), or other person(s)
having a recognized property interest. If there are multiple property owners/applicants, a signature
is required for each. 8/17/2020