Fillable RANDOLPH COUNTY PLANNING AND DEVELOPMENT PRELIMINARY PLAT/SUBDIVISION APPLICATION (Randolph County)

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RANDOLPH COUNTY PLANNING AND DEVELOPMENT PRELIMINARY PLAT/SUBDIVISION APPLICATION (Randolph County)

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Page 1 of 2 Rev. 7/19/2019
RANDOLPH COUNTY
PLANNING AND DEVELOPMENT
PRELIMINARY PLAT/SUBDIVISION APPLICATION
If you have questions or concerns about this application, please call Eric Martin at
(336) 318-6553 or Tim Mangum at (336) 318-6552.
This application is for the review process for preliminary major subdivision plats as
required by the Randolph County Unified Development Ordinance. The following
form must be completed and submitted in order for your preliminary plat to be
accepted for review. Please check the list on the document Preliminary Plat
Requirements for the items that must be included on the preliminary plat.
SUMMARY INFORMATION
Development name: _______________________________________________________________________
Location: ____________________________________________________________________________________
Randolph County Parcel Identification Number: _____________________________________
Total number of acres on plat: __________________________________________________________
Total number of lots on plat: ____________________________________________________________
Proposed zoning district: ________________________________________________________________
Proposed housing type: __________________________________________________________________
Proposed housing size: ___________________________________________________________________
PROPERTY OWNER INFORMATION
Property owner’s name: __________________________________________________________________
Property owner’s address: _______________________________________________________________
________________________________________________________________________________________________
Property owner’s telephone number: __________________________________________________
Property owner’s fax number if available: ____________________________________________
Property owner’s e-mail address if available: ________________________________________
Page 2 of 2 Rev. 7/19/2019
DEVELOPER INFORMATION
Developer’s name: _________________________________________________________________________
Developer’s address: ______________________________________________________________________
________________________________________________________________________________________________
Developer’s telephone number: ________________________________________________________
Developer’s fax number if available: ___________________________________________________
Developer’s e-mail address if available: _______________________________________________
REPRESENTATIVE INFORMATION
Representative’s name: ___________________________________________________________________
Representative’s address: ________________________________________________________________
________________________________________________________________________________________________
Representative’s telephone number: __________________________________________________
Representative’s fax number if available: _____________________________________________
Representative’s e-mail address if available: _________________________________________
ENGINEER/SURVEYOR INFORMATION
Engineers/surveyors name: _____________________________________________________________
Engineers/surveyors address: __________________________________________________________
________________________________________________________________________________________________
Engineers/surveyors telephone number: _____________________________________________
Engineers/surveyors fax number if available: ________________________________________
Engineers/surveyors e-mail address if available: ___________________________________
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RANDOLPH COUNTY PLANNING AND DEVELOPMENT PRELIMINARY PLATSUBDIVISION APPLICATION (Randolph County)

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Completed 6 August 2020

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