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Date Application Received: Date Application Certified as Complete: Applicant Name (Printed): Applicant email (Printed): Applicant Phone Number: Subdivision Name Applicant requests that the preliminary plat and final plat are acted upon in one application? Yes (See City Code section 6-3-3-2 to verify request is valid) No, the preliminary plat and final plat will be applied for separately Application shall contain the following: Preliminary Plat Review Base Fee $500.00 Preliminary Plat Review per Lot Fee $10.00 per lot **Office Use Only** Subdivision Application Form - Preliminary Plat Application Submit completed application to the Planning and Zoning Administrator Preliminary Plat Fees Six copies of the preliminary plat of the proposed subdivision drawn in accordance with the requirements hereinafter stated; each copy of the preliminary plat shall be on good quality paper, shall have dimensions of not less than twenty four inches by thirty six inches (24" x 36"), shall be drawn to a scale of not less than one inch to one hundred feet (1"=100'), shall show the drafting date, and shall indicate thereon, by arrow, the general northerly direction. Or PDF Copy Preliminary Plat Application April 2024 Page 1 of 5 ---PAGE BREAK--- The following shall be shown on the preliminary plat or shall be submitted separately: Six sets of preliminary engineering plans (not meant to be cross-sections or detailed designs) for streets, water, sewers, sidewalks and other required public improvements; however, such engineering plans shall contain sufficient information and detail to enable the Engineer to make a determination as to conformance of the proposed improvements to applicable regulations, ordinances and standards. Or PDF Copy Written application requesting approval of the preliminary plat (this document) Appropriate information that sufficiently details the proposed development within any special development area, such as hillside, planned unit development, flood plain, cemetery, mobile home, large scale development, hazardous and unique areas of development. (Ord. 901, 10-18-1976) The name of the proposed subdivision Applicant shall provide evidence that the applicant can sign this application on behalf of the property owner or developer or be said property owner or developer per section 6-2-1 (Subdivider) The names, addresses and telephone numbers of the subdivider or subdividers and the engineer or surveyor who prepared the plat. The name and address of all adjoining owners of property within a radius of three hundred feet (300') of the boundaries of the proposed subdivision, whether or not bisected by a public right of way as shown on record in the County Assessor's office. A statement of the intended use of the proposed subdivision, such as: residential single-family; two-family and multiple housing; commercial; industrial; recreational or agricultural and a showing of any sites proposed for parks, playgrounds, schools, churches or other public uses. The legal description of the subdivision (One paper or electronic PDF copy and one electronic copy in Microsoft Word format) Preliminary Plat Application April 2024 Page 2 of 5 ---PAGE BREAK--- Yes, a copy is included No, there are none proposed at this time Any proposed or existing utilities, including, but not limited to, storm and sanitary sewers, irrigation laterals, ditches, drainages, bridges, culverts, water mains, fire hydrants, electric lines, gas lines, telephone lines and other similar utilities. A copy of any proposed restrictive covenants and/or deed restrictions. Any dedications to the public and/or easements, together with a statement of location, dimensions and purposes of such. Information required for chapter 5 of this title shall be furnished on all subdivisions. A vicinity map showing the relationship of the proposed plat to the surrounding area (1/2 mile minimum radius, scale optional). The land use and existing zoning of the proposed subdivision and the adjacent land. Streets, street names, rights of way and roadway widths, including adjoining streets or roadways. Lot lines and blocks showing the dimensions and numbers of each. Contour lines, shown at five foot intervals where land slope is greater than ten percent (10%) and at two foot intervals where land slope is ten percent (10%) or less, referenced to an established bench mark, including location and elevation. A site report showing proposed water supply and sewage disposal systems. A map of the entire area scheduled for development if the proposed subdivision is a portion of a larger holding intended for subsequent Preliminary Plat Application April 2024 Page 3 of 5 ---PAGE BREAK--- Yes, a copy is included No, there is no variance requested Additional information provided by the applicant (if any): A statement as to whether or not a variance, as specified in chapter 7 of this title, will be requested with respect to any provision of this title describing the particular provision, the variance requested, and the reasons therefor. (Ord. 901, 10- 18-1976) Preliminary Plat Application April 2024 Page 4 of 5 ---PAGE BREAK--- Applicant Signature: Date: By signing, you are confirming you have provided all required items listed on this application This application shall not be considered complete (nor will a Public Hearing be scheduled) until Staff has received all required information. Once the application is deemed complete, Staff will notify the Applicant of the scheduled hearing date, fees due, and/or any additional items. Preliminary Plat Application April 2024 Page 5 of 5 ---PAGE BREAK--- Y N N/A Y N N/A 1 6-6-5 Large Scale Development (50 or more residential dwelling units) 2 6-6 Type of Development (Single Family, Condo, PUD, Multi Family, Mixed, Commercial) 3 6-3-3-3(A) 6 paper copies or PDF if electronic submission 4 6-3-3-3(A) 24x36 sheets 5 6-3-3-3(A) Scale not less than 1"=100' 6 6-3-3-3(A) Drafting Date 7 6-3-3-3(A) North Arrow 8 6-3-3-3(B) Shows Streets, Sidewalks, water, & sewer lines, and other public improvements that may be required for the subdivision 9 6-3-3-3(C)Written Application to accept the preliminary plat 10 6-3-3-3(D) Sufficient details within any special development area such as hillside, cemetery, flood plain, mobile home, large development or other hazard areas 11 6-3-3-4(A) Name of the Subdivision 12 6-3-3-4(B) Name , address, and phone number of developer, subdivider(s) and engineer-surveyor that prepared the preliminary plat 13 6-3-3-4(C)Name and address of all adjoining property owners within 300 feet of boundary 14 6-3-3-4(D) Legal Description of the subdivision 15 6-3-3-4(E)Statement of the intended use of the subdivision 16 6-3-3-4(E)Any sites proposed for parks, schools, churches, or other public spaces 17 6-3-3-4(F) Map of the entire area planned for development if not part of this preliminary plat 18 6-3-3-4(G) Vicinity Map showing 1/2 mile outside of the preliminary plat area 19 6-3-3-4-(H) Land use and existing zoning for the preliminary plat area and surrounding areas 20 6-3-3-4-(I) Streets, street names, right of way, roadway widths, including adjoining streets 21 6-3-3-4(J) Lot lines and blocks showing dimensions of each 22 6-3-3-4(K) Existing and proposed contour lines at not more than 2-foot contours contours if the development is more than 10% slope 23 6-3-3-4(L) Site report showing water supply and sewer disposal systems 24 6-3-3-4(M) Proposed and existing utilities including but not limited to water, irrigation lines, irrigation ditches, storm drain, sewer, fire hydrants, electric lines, gas lines, phone lines, bridges, and similar utilities 25 6-3-3-4(N) A copy of any proposed restrictive covenants and restrictions (CCR) & HOA 26 6-3-3-4(O) Any dedications to the public or easements with location, dimensions, and purpose 27 6-3-3-4-(Q) Statement if a variance is requested or not 28 Review by Irrigation District if subdivision abuts an irrigation canal Preliminary Plat Checklist Applicant City 26-Apr-24 No Description