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Sketch Plan Application
A Sketch Plan is a scaled drawing that is not required to be certified due to the
minimal changes to an existing site and is allowed when one of the following
conditions exist: (please check the appropriate box)
Change of Use where no exterior site improvements are required
other than possibly landscaping or parking lot striping.
Commercial stables Change of Use utilizing existing structures or
minor proposed improvements.
Public park structures (ie shelter house, bathroom, playgrounds).
Modifications to an existing approved site plan on file with Polk
County, where no additional hard surface is proposed (ie: building
constructed on existing paved surface and adequate parking
provided.)
If sketch plan cannot adequately provide necessary detail or if existing site factors do
not adequately provide appropriate drainage or detention a minor or major site plan as
determined by the Zoning Administrator shall be submitted for the project.
.1. Subject Property Information
____________________________________________________________
Property Address or Parcel Number
______________________________
Zoning District
_______________________________ _______________________________
Current Use Proposed Use
2. Applicant Information
__________________________________________ __________________________________________
Applicant (Print Name) Interest in Property (owner, consultant, prospective buyer)
____________________________________________________________________
Address, City, State and Zip
___________________________________ ________________________________
Email Phone
2. Property Owner Information
__________________________________________
Property Owner (Print Name)
___________________________________________ ______________________________________________
Email Phone
3. Consultant Information
__________________________________________ __________________________________________
Company Name Project Contact
____________________________________________________________________
Address, City, State and Zip
___________________________________________ ______________________________________________
Email Phone
(time stamp)
Official Use Only
