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1 PRELIMINARY SUBDIVISION PLAT APPLICATION PART I GENERAL DESCRIPTION AND INFORMATION 1. Name of the proposed subdivision 2. Location (City and/or Legal description: of Section Township Range______ 3. Type of water supply system: a. Individual surface water supply from spring b. Multiple-family water supply system (3-14 connections and fewer than 25 people) c. Service connection to multiple-family system d. Service connection to public system e. Extension of public main f. New public system g. Individual well 4. Type of wastewater treatment system: a. Individual or shared on-site septic system b. Multiple-family on-site system (3-14 connections and fewer than 25 people) c. Service connection to multiple-family system d. Service connection to public system e. Extension of public main f. New public system 5. Is information included which substantiates that there will be no degradation of state ---PAGE BREAK--- 2 waters or that degradation will be nonsignificant? 6. Descriptive Data: a. Number of lots or rental spaces b. Total acreage in lots being reviewed c. Total acreage in streets or roads d. Total acreage in parks, open space, and/or common facilities e. TOTAL gross acreage of subdivision f. Minimum size of lots or g. Maximum size of lots or spaces 7. Indicate the proposed use(s) and number of lots or spaces in each: ________Residential, single family ________Residential, multiple family of multiple family structures and numbers of each (e.g. duplex) ________Planned Unit Development (Number of units ) ________Condominium (Number of units ) ________Mobile Home Subdivision (Number of spaces ) ________Recreational Vehicle Subdivision (Number of spaces ) ________Commercial or Industrial (please describe) 8. Provide the following information regarding the development: a. Current land use b. Existing zoning or other regulations ---PAGE BREAK--- 3 c. Depth to ground water at the time of year when water table is nearest to the natural ground surface within the drainfield area d. Depth to bedrock or other impervious material in the drainfield area e. If a tract of land is to be subdivided in phases, an overall development plan indicating the intent for the development of the remainder of the tract. f. Drafts of any covenants and restrictions to be included in deeds or contracts for sale. Drafts of homeowners’ association bylaws and articles of incorporation, if applicable. (Submitting a draft copy of a homeowners’ association bylaws and articles of incorporation is adequate for DEQ to initiate and complete its review of sanitary facilities, but a copy of the fully executed documents must be submitted before DEQ can issue final approval.) g. Indicate whether the mineral rights have been severed from the property: h. Indicate whether water rights have been severed from the property: 9. Is the applicant claiming an exemption under Section 7-A-2 of the subdivision regulations from the requirement to prepare an environmental assessment? Name, address, and telephone number of designated representative, if any engineer, surveyor). Name Phone Address (Street or P.O. Box, City, State, Zip Code) ---PAGE BREAK--- 4 Name, address, and telephone number of owner(s). Name Address (Street or P.O. Box, City, State, Zip Code) Date Phone Signature of owner Name, address, and telephone number of subdivider if different than owner(s). Name Address (Street or P.O. Box, City, State, Zip Code) Date Phone Signature of subdivider The application must be signed by the owner of the land proposed for subdivision or the responsible officer of the corporation offering the same for sale. ---PAGE BREAK--- 5 PART II PRELIMINARY PLAT FORM, CONTENTS AND SUPPLEMENTS 1. Preliminary Plat Subdivision Application Form: The subdivider shall submit a completed subdivision application form that is signed by the landowner(s) of record. 2. Preliminary Plat Review Fee: The subdivider shall submit the required review fee as identified in the pre-application meeting and in Section 18-G of the subdivision regulations. 3. Preliminary Plat Form, Contents, and Supplements: The subdivider shall submit an 11” by 17” and an 18” by 24” (or 24” by 36”) preliminary plat completed by a land surveyor. The following information must be provided on the preliminary plat or in supplements to the preliminary plat: a. The subdivision or development name (the title must contain the words “plat” and/or “subdivision”) b. The legal description, including Section, Township, and Range, and any underlying survey data; c. A north arrow; d. The scale used on the plat; e. The certification of a professional land surveyor; f. The certification of a professional engineer (if the preliminary plat application or data includes engineering plans or specifications); g. The names of all owners of record and the subdivider [if different from the owner(s)]; h. The date the preliminary plat is completed; i. Proposed lot layout with approximate dimensions and sizes; j. Lots and blocks identified by number or letter; k. The use of each lot, if other than for single-family residential; l. The exterior boundaries of the parcel proposed for subdivision with bearings, distances, and curve data indicated outside of the boundary lines. When the plat is bounded by an irregular shoreline or body of water, the bearings and distances of a closing meander traverse shall be given; m. All existing streets, roads, highways, avenues, alleys, and/or access easements within or adjacent to the subject property; n. All proposed streets, roads, alleys, avenues, and easements; the width of the easement or right-of-way, grades, curvature of each; o. Existing and proposed road and street names; p. Proposed location of intersections for any subdivision requiring access to state or local streets, roads, avenues, alleys, or highways; q. The names of adjoining platted subdivisions and recording information from adjoining subdivisions, certificates of survey, or unplatted lands; r. The approximate location of all section corners or legal subdivision corners of ---PAGE BREAK--- 6 sections pertinent to the subdivision boundary; s. Approximate area, location, boundaries, and dimensions of all parks, common grounds, and other grounds dedicated for public use; t. The total gross area of the subdivision and the total net area, exclusive of public areas and rights-of-way; u. Existing and proposed infrastructure and proposed utilities including: The approximate location, size, and depth of existing and proposed sanitary and storm sewers; The approximate location, size, and depth of existing and proposed water mains, lines, wells, and facilities; and The approximate locations of gas lines, fire hydrants or firefighting water storage facilities, electric and telephone lines, and streetlights. 4. A vicinity sketch showing: a. The approximate locations of all existing buildings, structures, and other improvements; b. Ownership of lands immediately adjoining a subdivision, and existing buildings, structures and other improvements on those lands; and c. Any existing or proposed zoning of the tract and adjacent lands, if applicable. 5. A topographic map: a. For any land area which will be subdivided or disturbed, contour intervals of 2’ where the average slope is less than 10%; intervals of five feet where the average slope is greater than 10% and less than 15%; and intervals of ten feet where the average slope is 15% or greater. b. Slopes greater than 25% shall be shown as no-build zones. 6. A grading and drainage plan that includes: a. Proposed grades of all streets and roads; b. Proposed drainage facilities for all lots, blocks, and other areas displaying accurate dimensions, courses, and elevations; c. Existing and proposed contours, using the contour requirements of a topography map; d. Graded slopes; e. Proposed storm water drainage designed in accordance with standards specified by the Department of Public Works and the Montana Department of Environmental Quality; and f. Construction procedures, slope protection, or information describing the ultimate destinations of storm runoff used to minimize erosion; and g. Slope Stability Report shall be completed if the proposed subdivision includes areas with the potential for landsliding or slope instability. The report must be completed by a qualified soil or geotechnical engineer and indicate the locations, character, and extent of all areas of all slope stability, and these areas shall be shown on the plat. ---PAGE BREAK--- 7 7. Engineering plans for all public and private improvements; 8. Overall development plan and if the improvements are to be completed in phases, the approximate area of each phase shall be shown on the plat. 9. Abstract of Title (or Title Report) dated not more than 90 days prior to the date of submittal; 10. Lien holders’ Acknowledgement of Subdivision for each lien holder identified on the Abstract of Title or Title Report; 11. Documentation of legal and physical access; 12. Documentation of existing easements, including those for Agricultural Water User Facilities; 13. Existing covenants and deed restrictions; 14. Existing water rights; 15. Existing mineral rights; 16. Names and addresses of all adjoining property owners; 17. A proposed road plan and profile that includes: a. Street names (to be approved by the B-SB Addressing Coordinator.) b. Right-of-way or easement widths; c. Pavement widths; d. Street grades; e. Pavement and base thickness; f. Typical cross sections for each type of road; g. Road profiles and cross sections for all proposed streets and roads which have grades exceeding or cuts and fills exceeding h. The type and location of sidewalks and curbs (where required); i. The minimum site distances at corners; j. The minimum curb radiuses at corners; k. For cul-de-sac streets: widths of turn around radiuses; minimum right-of-way widths at the turnarounds; minimum pavement or road surface width at the turnarounds; total of the streets. l. The locations and characteristics of bridges and culverts; m. The locations and dimensions of adjoining lots and open spaces; n. The locations and widths of easements and dedicated land, which provide a buffer between the subdivision lots and streets; o. Typical grading and location of intersections with private driveways; and ---PAGE BREAK--- 8 p. Description of how the roads will be maintained. 18. Approach/access/encroachment permits from Montana Department of Transportation or the local jurisdiction; 19. Proposed easements; 20. Proposed disposition of water rights, as required by Section 11-L of the subdivision regulations; 21. Proposed disposition of mineral rights; 22. Parkland dedication calculations, including a property valuation assessment or appraisal if cash-in-lieu of parkland is proposed; 23. Environmental Assessment and/or Summary of Probable Impacts including: a. proof that the subdivider has submitted for review copies of the subdivision application and environmental assessment, if applicable, to the public utilities and agencies of the local, state, and federal government identified during the pre- application meeting or subsequently identified as having an interest in the proposed subdivision; and b. an explanation of how the subdivider has responded to the comments of the subdivision administrator at the pre-application meeting. 24. Transportation Impact Analysis or Transportation Plan; 25. Fire Risk Rating Analysis and Fire Prevention Plan as required in Appendix A of the subdivision regulations; 26. Weed Management Plan and Re-vegetation Plan; 27. FIRM or FEMA panel map and/or letter identifying floodplain status and other hydrologic characteristics including surface water bodies, designated floodplain and areas of riparian resource, as required in Section 11-G of the subdivision regulations and paragraph 34 of this Part II. 28. Required water and sanitation information, including: a. Provide the following attachments to the preliminary plat: A vicinity map or plan that shows: a) The location, within 100 feet outside of the exterior of the property line of the subdivision and on the proposed lots, of: 1. floodplains; 2. surface water features; 3. springs; 4. irrigation ditches; ---PAGE BREAK--- 9 5. existing, previously approved, and for parcels less than 20 acres, proposed water wells and wastewater treatment systems; 6. for parcels less than 20 acres, mixing zones identified as provided in subsection c; and 7. the representative drainfield site used for the soil profile description as required under subsection c; and b) The location, within 500 feet outside of the exterior property line of the subdivision, of public water and sewer facilities. A description of the proposed subdivision’s water supply systems, storm water systems, solid waste disposal systems, and wastewater treatment systems, as provided below, including whether the water supply and wastewater treatment systems are individual, shared, multiple user, or public as those systems are defined in rule published by the DEQ; A drawing of the conceptual lot layout at a scale no smaller than 1 inch equal to 200 feet that shows all information required for a lot layout document in rules adopted by DEQ pursuant to 76-4-104; b. Water Supply High Groundwater Report indicating there is not a problem with high groundwater present on the property proposed for subdivision. When evidence of high groundwater is present, the developer must submit plans that are prepared by a professional engineer to mitigate the problem; A vicinity map or plan that shows: a) the location, within 100’ outside of the exterior property line of the subdivision and on the proposed lots of: 1. floodplains; 2. surface water features; 3. springs; 4. irrigation ditches; 5. existing, previously approved, and, for parcels less than 20 acres, proposed water wells and wastewater treatment systems; 6. for parcels less than 20 acres, mixing zones identified as provided in subsection c. below. b) the location, within 500’ outside the exterior property line of the subdivision, of public water and sewer facilities; A description of the proposed subdivision’s water supply systems, storm water systems, solid waste disposal systems, and wastewater treatment systems, including whether the water supply and wastewater treatment systems are individual, shared, multiple user, or public as those systems are defined in rules published by the Department of Environmental Quality in the Administrative Rules of Montana, or 76-4-101 et seq., MCA, including the following information: a) If an individual water supply system is proposed for each parcel: 1. Indicate the distance to the nearest public water system. ---PAGE BREAK--- 10 2. Attach a copy of the lot layout showing the proposed location of each spring, well, or cistern and indicating the distance to existing or proposed wastewater treatment systems. 3. Evidence of sufficient water quality in accordance with rules adopted by the DEQ pursuant to 76-4-104; b) For a multiple user water system: 1. If an existing system is to be used: a. identify the system and the person, firm, or agency responsible for its operation and maintenance; b. indicate the system’s capacity to handle additional load and its distance from the development; c. provide evidence that permission to connect to the system has been granted; 2. provide the following attachments: a. map or plat showing location, sizes, and depth of any existing water supply lines and facilities which may directly serve parcels within the proposed development; b. provide plans and specifications for all proposed extensions and additional lines and facilities as required by ARM 17.38.305 and Circular DEQ 3. 3. evidence of sufficient water quality in accordance with rules adopted by the DEQ pursuant to 76-4-104; c) Where a new system is proposed: a. Provide evidence of adequate water availability, unless cisterns are proposed: i. obtained from well logs or testing of onsite or nearby wells; ii. obtained from information contained in published hydrogeological reports; or iii. as otherwise specified by rules adopted by the DEQ pursuant to 76-4-104; b. indicate who will install the system, who will bear the costs, when it will be completed, and who will own it; c. provide all information required in ARM 17.36.330-336 and Circular DEQ-3. d. Evidence of sufficient water quality in accordance with rule adopted by the DEQ pursuant to 76-4-104; d) For a public water system: 1. If an existing system is to be used: a. identify the system and the person, firm, or agency responsible for its operation and maintenance; b. indicate the system’s capacity to handle additional load and its distance from the development; c. provide evidence that permission to connect has been ---PAGE BREAK--- 11 granted; d. provide the following as attachments: i. a map or plat showing the location, sizes, and depth of any existing water lines and facilities which will directly serve parcels within the proposed development; ii. plans and specifications for all proposed extensions and additional lines and facilities as required by ARM 17.36.328-330 and Circular DEQ-1 or Circular DEQ-3. iii. Evidence of sufficient water quality in accordance with rule adopted by the DEQ pursuant to 76-4-104; 2. If a new system is proposed: a. Provide evidence of adequate water availability: i. obtained from well logs or testing of onsite or nearby wells; ii. obtained from information contained in published hydrogeological reports; or iii. as otherwise specified by rules adopted by the DEQ pursuant to 76-4-104; b. indicate who will install the system, who will bear the costs, when it will be completed, and who will own it; c. provide plans and specifications for all proposed extensions and additional lines and facilities as required by ARM 17.36.328-330 and Circular DEQ-1 or Circular DEQ-3. d. Evidence of sufficient water quality in accordance with rules adopted by the DEQ pursuant to 76-4-104; c. Wastewater Treatment System For new onsite wastewater treatment systems, evidence of suitability that at a minimum includes: a) a soil profile description from a representative drainfield site identified on the vicinity map that complies with the standards published by DEQ; b) demonstration that the soil profile contains a minimum of 4 feet of vertical separation distance between the bottom of the permeable surface of the proposed wastewater treatment system and a limiting layer; and c) in cases in which the soil profile or other information indicates that ground water is within 7 feet of the natural ground surface, evidence that the ground water will not exceed the minimum vertical separation distance provided in section above. 1. For all new wastewater treatment systems a preliminary analysis of potential impacts to ground water quality using ---PAGE BREAK--- 12 as guidance rules adopted by the board of environmental review pursuant to 75-5-301 and 75-5-303 related to standard mixing zones for ground water, source specific mixing zones, and nonsignificant changes in water quality. The preliminary analysis may be based on currently available information and must consider the effects of overlapping mixing zones from proposed and existing wastewater treatment systems within and directly adjacent to the subdivision. Instead of performing the preliminary analysis required under this subsection the subdivider may perform a complete nondegradation analysis in the same manner as is required for an application that is reviewed under Title 76, chapter 4. If individual wastewater treatment systems are proposed for each parcel: Indicate the distance to the nearest public wastewater treatment system. b) Provide all information required in ARM 17.36.320-345 and in Circular DEQ-4 for conventional systems or Circular DEQ 5 for alternative systems. c) evidence of suitability as provided in subsection of this section d) preliminary analysis of potential impact to ground water as provided in subsection of this section. For a multiple-user wastewater treatment system: a) If an existing system is to be used: 1. identify the system and the person, firm, or agency responsible for its operation and maintenance; 2. indicate the system’s capacity to handle additional load and its distance from the development; 3. provide evidence that permission to connect to the system has been granted; 4. provide the following attachments: a. a map or plat showing the location, sizes, and depth of any existing sewer lines and facilities which will directly serve parcels within the proposed development; and b. plans and specifications for all proposed extensions and additional lines and facilities as required by ARM 17.36.320-345 and Circular DEQ-4 or Circular DEQ-5. b) If a new system is proposed: 1. indicate who will install the system, who will bear the costs, when it will be completed, and who will own it; 2. provide all information required in ARM 17.36.320-326 and Circular DEQ-4 or Circular DEQ-5. 3. evidence of suitability as provided in subsection of this ---PAGE BREAK--- 13 section. 4. preliminary analysis of potential impact to ground water as provided in subsection of this section. For a public wastewater treatment system: a) If an existing system is to be used: 1. identify the system and the person, firm, or agency responsible for its operation and maintenance; 2. indicate the system’s capacity to handle additional load and its distance from the development; 3. provide evidence that permission to connect to the system has been granted; 4. provide the following attachments: a. a map or plat showing the location, sizes, and depth of any existing sewer lines and facilities which will directly serve parcels within the proposed development; b. plans and specifications for all proposed extensions and additional lines and facilities as required by ARM 17.36.328 and Circular DEQ-2 or Circular DEQ-4. d. Storm Water Describe measures for the collection and disposal of storm run-off from streets and roads within the subdivision. Indicate the type of road surface proposed. Describe facilities for stream or drainage crossing culverts, bridges). Describe how surface run-off will be drained or channeled from parcels. Indicate whether storm run-off will enter state waters and describe any proposed treatment measures. (A storm-water discharge permit may be required) Describe any existing or proposed streambank or shoreline alteration, and any proposed construction or modification of lake beds or stream channels. Provide information on location, extent, type, and purpose of alteration. Provide the grading and storm water or drainage plan as required by section II-3 Preliminary Plat Supplements, subsection of this appendix. e. Solid Waste Describe the proposed method of solid waste collection and disposal. If use of an existing collection system or disposal facility is proposed, indicate the name and location of the facility. If on-site disposal of solid waste is proposed, provide the information required in ARM 17.36.309(2). 29. A form of Subdivision Improvements Agreement, if proposed; 30. Letter requesting a revocation of agricultural covenants; 31. Letter indicating locations of cultural or historic resources; ---PAGE BREAK--- 14 32. Variance request or approval; 33. Re-zoning application or approval; 34. When required, a flood hazard evaluation which contains the following detailed information: [to be submitted to the Water Resources Division, Department of Natural Resources]: a. Certification by a registered professional engineer; b. An overall scaled plan view with identified scale for vertical and horizontal distance showing the following: Watercourse Floodplain boundaries Location of property Contours Cross-sections Bridges or other contractions in the floodplains USGS gauging stations (if any); c. The location and elevation of a temporary benchmark(s) established within the subdivision and referenced to mean sea level with appropriate elevation adjustment. d. Cross-sectional information which contains the following information: Elevations and stations that are determined at points representing significant breaks in ground slope and at changes in the hydraulic characteristics of the floodplain points where ground cover, soil, or rock conditions change). Elevations must be reported in NAVD 88 or NGVD 29 datum. Each cross-section must cross the entire floodplain. The cross-section alignment should be perpendicular to the general flow of the watercourse (approximately perpendicular to contour lines). Occasionally, wide floodplains require a dog-leg alignment to be perpendicular to the anticipated flow lines. Shots should be taken at the water’s edge and measurements taken (if elevation shots cannot be taken) to determine the channel bottom shape. Cross sections must be accurately located on a USGS 7 ½ minute quad sheet. The number of cross-sections needed, and the distance between cross- sections, will vary depending on the site, the slope of the watercourse, the slope of the channel, and the hydraulic characteristics of the reach. A minimum of four cross sections are required over the entire reach with at least two cross-sections at the property where the elevations are desired. Additional cross-sections must be taken at bridges, control structures, or natural constrictions in topography. [Photogrammetric methods may be used in lieu of cross sections whenever appropriate and when reviewed and approved by the county.] ---PAGE BREAK--- 15 e. A description and sketch of all bridges within the reach, showing unobstructed waterway openings and elevations. f. Elevation of the water surface is to be determined by survey as part of each valley cross section. g. Supporting Documentation, such as engineering reports of computer computations, calculations, and assumptions that may include: i. Hydrology (research of published hydrology or calculations showing how hydrology was derived) ii. Input files (hardcopy and on diskette) iii. Output files (diskette only) 35. Letter identifying and proposing mitigation for potential hazards or other adverse impacts as identified in the pre-application meeting and not covered by any of the above required materials; and 36. Such additional relevant and reasonable information as identified by the Subdivision Administrator during the pre-application meeting that is pertinent to the required elements of this section. PART III ENVIRONMENTAL ASSESSMENT Information specified in this Part must be provided in addition to that required in parts I and II of this application form, unless the proposed subdivision qualifies for an exemption under Section 7-A-2 of the subdivision regulations. Describe the following environmental features, provide responses to each of the following questions and provide reference materials as required. 1. Surface Water Locate on a plat overlay or sketch map: a. Any natural water systems such as streams, rivers, intermittent streams, lakes or marshes (also indicate the names and sizes of each). b. Any artificial water systems such as canals, ditches, aqueducts, reservoirs, and irrigation systems (also indicate the names, sizes and present uses of each). c. Time when water is present (seasonally or all year). d. Any areas subject to flood hazard, or in delineated 100 year floodplain. ---PAGE BREAK--- 16 e. Describe any existing or proposed streambank alteration from any proposed construction or modification of lake beds or stream channels. Provide information on location, extent, type and purpose of alteration, and permits applied for. 2. Groundwater Using available data, provide the following information: a. The minimum depth to water table and identify dates when depths were determined. What is the location and depth of all aquifers which may be affected by the proposed subdivision? Describe the location of known aquifer recharge areas which may be affected. b. Describe any steps necessary to avoid depletion or degradation of groundwater recharge areas. 3. Topography, Geology and Soils a. Provide a map of the topography of the area to be subdivided, and an evaluation of suitability for the proposed land uses. On the map identify any areas with highly erodible soils or slopes in excess of 15% grade. Identify the lots or areas affected. Address conditions such as: Shallow bedrock Unstable slopes Unstable or expansive soils Excessive slope b. Locate on an overlay or sketch map: Any known hazards affecting the development which could result in property damage or personal injury due to: A. Falls, slides or slumps soil, rock, mud, snow. B. Rock outcroppings C. Seismic activity. D. High water table c. Describe measures proposed to prevent or reduce these dangers. d. Describe the location and amount of any cut or fill more than three feet in depth. Indicate these cuts or fills on a plat overlay or sketch map. Where cuts or fills are necessary, describe plans to prevent erosion and to promote vegetation such as replacement of topsoil and grading. 4. Vegetation ---PAGE BREAK--- 17 a. On a plat overlay or sketch map: Indicate the distribution of the major vegetation types, such as marsh, grassland, shrub, coniferous forest, deciduous forest, mixed forest. Identify the location of critical plant communities such as: A. Stream bank or shoreline vegetation B. Vegetation on steep, unstable slopes C. Vegetation on soils highly susceptible to wind or water erosion D. Type and extent of noxious weeds b. Describe measures to: Preserve trees and other natural vegetation (e.g. locating roads and lot boundaries, planning construction to avoid damaging tree cover). Protect critical plant communities (e.g. keeping structural development away from these areas), setting areas aside for open space. Prevent and control grass, brush or forest fires (e.g. green strips, water supply, access.) Control and prevent growth of noxious weeds 5. Wildlife a. Identify species of fish and wildlife use the area affected by the proposed subdivision. b. On a copy of the preliminary plat or overlay, identify known critical wildlife areas, such as big game winter range, calving areas and migration routes; riparian habitat and waterfowl nesting areas; habitat for rare or endangered species and wetlands. c. Describe proposed measures to protect or enhance wildlife habitat or to minimize degradation (e.g. keeping buildings and roads back from shorelines; setting aside wetlands as undeveloped open space). Part IV SUMMARY OF PROBABLE IMPACTS Summarize the effects of the proposed subdivision on each topic below. Provide responses to the following questions and provide reference materials as required: 1. Effects on Agriculture ---PAGE BREAK--- 18 a. Is the proposed subdivision or associated improvements located on or near prime farmland or farmland of statewide importance as defined by the Natural Resource Conservation Service? If so, identify each area on a copy of the preliminary plat. b. Describe whether the subdivision would remove from production any agricultural or timber land. c. Describe possible conflicts with nearby agricultural operations residential development creating problems for moving livestock, operating farm machinery, maintaining water supplies, controlling weeds or applying pesticides; agricultural operations suffering from vandalism, uncontrolled pets or damaged fences). d. Describe possible nuisance problems which may arise from locating a subdivision near agricultural or timber lands. e. Describe effects the subdivision would have on the value of nearby agricultural lands. 2. Effects on Agricultural Water User Facilities a. Describe conflicts the subdivision would create with agricultural water user facilities (e.g. residential development creating problems for operating and maintaining irrigation systems) and whether agricultural water user facilities would be more subject to vandalism or damage because of the subdivision. b. Describe possible nuisance problems which the subdivision would generate with regard to agricultural water user facilities (e.g. safety hazards to residents or water problems from irrigation ditches, head gates, siphons, sprinkler systems, or other agricultural water user facilities). 3. Effects on Local Services a. Indicate the proposed use and number of lots or spaces in each: Residential, single family Residential, multiple family Types of multiple family structures and number of each (e.g. duplex, 4- plex) Planned unit development (No. of units) Condominium (No. of units) Mobile Home Park Recreational Vehicle Park Commercial or Industrial Other (Please describe ) ---PAGE BREAK--- 19 b. Describe the additional or expanded public services and facilities that would be demanded of local government or special districts to serve the subdivision. Describe additional costs which would result for services such as roads, bridges, law enforcement, parks and recreation, fire protection, water, sewer and solid waste systems, schools or busing, (including additional personnel, construction, and maintenance costs). Who would bear these costs (e.g. all taxpayers within the jurisdiction, people within special taxing districts, or users of a service)? Can the service providers meet the additional costs given legal or other constraints (e.g. statutory ceilings on mill levies or bonded indebtedness)? Describe off-site costs or costs to other jurisdictions may be incurred (e.g. development of water sources or construction of a sewage treatment plant; costs borne by a nearby municipality). c. Describe how the subdivision allows existing services, through expanded use, to operate more efficiently, or makes the installation or improvement of services feasible (e.g. allow installation of a central water system, or upgrading a country road). d. What are the present tax revenues received from the unsubdivided land? By the County $ By the municipality if applicable By the school(s) $ e. Provide the approximate revenues received by each above taxing authority if the lots are reclassified, and when the lots are all improved and built upon. Describe any other taxes that would be paid by the subdivision and into what funds (e.g. personal property taxes on mobile/manufactured homes are paid into the County general fund). f. Would new taxes generated from the subdivision cover additional public costs? g. How many special improvement districts would be created which would obligate local government fiscally or administratively? Are any bonding plans proposed which would affect the local government's bonded indebtedness? 4. Effects on the Historic or Natural Environment a. Describe and locate on a plat overlay or sketch map known or possible historic, paleontological, archaeological or cultural sites, structures, or objects which may ---PAGE BREAK--- 20 be affected by the proposed subdivision. b. How would the subdivision affect surface and groundwater, soils, slopes, vegetation, historical or archaeological features within the subdivision or on adjacent land? Describe plans to protect these sites. Would any streambanks or lake shorelines be altered, streams rechanneled or any surface water contaminated from sewage treatment systems, run-off carrying sedimentation, or concentration of pesticides or fertilizers? Would groundwater supplies likely be contaminated or depleted as a result of the subdivision? Would construction of roads or building sites require cuts and fills on steep slopes or cause erosion on unstable, erodible soils? Would soils be contaminated by sewage treatment systems? Describe the impacts that removal of vegetation would have on soil erosion, bank, or shoreline instability. Would the value of significant historical, visual, or open space features be reduced or eliminated? Describe possible natural hazards the subdivision could be subject to natural hazards such as flooding, rock, snow or land slides, high winds, severe wildfires, or difficulties such as shallow bedrock, high water table, unstable or expansive soils, or excessive slopes). c. How would the subdivision affect visual features within the subdivision or on adjacent land? Describe efforts to visually blend the proposed development with the existing environment (e.g. use of appropriate building materials, colors, road design, underground utilities, and revegetation of earthworks). 5. Effects on Wildlife and Wildlife Habitat a. Describe what impacts the subdivision or associated improvements would have on wildlife areas such as big game wintering range, migration routes, nesting areas, wetlands, or important habitat for rare or endangered species. b. Describe the effect that pets or human activity would have on wildlife. 6. Effects on the Public Health and Safety a. Describe any health or safety hazards on or near the subdivision, such as: natural hazards, lack of water, drainage problems, heavy traffic, dilapidated structures, ---PAGE BREAK--- 21 high pressure gas lines, high voltage power lines, or irrigation ditches. These conditions, proposed or existing should be accurately described with their origin and location identified on a copy of the preliminary plat. b. Describe how the subdivision would be subject to hazardous conditions due to high voltage lines, airports, highways, railroads, dilapidated structures, high- pressure gas lines, irrigation ditches, and adjacent industrial or mining uses. c. Describe land uses adjacent to the subdivision and how the subdivision will affect the adjacent land uses. Identify existing uses such as feed lots, processing plants, airports or industrial firms which could be subject to lawsuits or complaints from residents of the subdivision. d. Describe public health or safety hazards, such as dangerous traffic, fire conditions, or contamination of water supplies which would be created by the subdivision. Part V Community Impact Report Provide a community impact report containing a statement of estimated number of people coming into the area as a result of the subdivision, anticipated needs of the proposed subdivision for public facilities and services, the increased capital and operating cost to each affected unit of local government. Provide responses to each of the following questions and provide reference materials as required. 1. Education and Busing a. Describe the available educational facilities which would serve this subdivision. b. Estimate the number of school children that will be added by the proposed subdivision. Provide a statement from the administrator of the affected school system indicating whether the increased enrollment can be accommodated by the present personnel and facilities and by the existing school bus system. If not, estimate the increased expenditures that would be necessary to do so. 2. Roads and Maintenance a. Estimate how much daily traffic the subdivision, when fully occupied, will generate on existing streets and arterials. b. Describe the capability of existing and proposed roads to safely accommodate this increased traffic. c. Describe increased maintenance problems and increased cost due to this increase in volume. ---PAGE BREAK--- 22 d. Describe proposed new public or private access roads including: Measures for disposing of storm run-off from streets and roads. Type of road surface and provisions to be made for dust. Facilities for streams or drainage crossing (e.g. culverts, bridges). Seeding of disturbed areas. e. Describe the closing or modification of any existing roads. f. Explain why road access was not provided within the subdivision, if access to any individual lot is directly from arterial streets or roads. g. Is year-round access by conventional automobile over legal rights-of-way available to the subdivision and to all lots and common facilities within the subdivision? Identify the owners of any private property over which access to the subdivision will be provided. h. Estimate the cost and completion date of the system, and indicate who will pay the cost of installation, maintenance and snow removal. 3. Water, Sewage, and Solid Waste Facilities a. Briefly describe the water supply and sewage treatment systems to be used in serving the proposed subdivision (e.g. methods, capacities, locations). b. Provide information on estimated cost of the system, who will bear the costs, and how the system will be financed. c. Where hook-up to an existing system is proposed, describe estimated impacts on the existing system, and show evidence that permission has been granted to hook up to the existing system. d. All water supply and sewage treatment plans and specifications will be reviewed and approved by the Department of Environmental Quality (DEQ) and should be submitted using the appropriate DEQ application form. e. Describe the proposed method of collecting and disposing of solid waste from the development. f. If use of an existing collection system or disposal facility is proposed indicate the name and location of the facility. 4. Fire and Police Protection ---PAGE BREAK--- 23 a. Describe the fire and police protection services available to the residents of the proposed subdivision including number of personnel and number of vehicles or type of facilities for: Fire protection is the proposed subdivision in an existing fire district? If not, will one be formed or extended? Describe what fire protection procedures are planned? b. Can the fire and police protection service needs of the proposed subdivision be met by present personnel and facilities? If not, describe the additional expenses that would be necessary to make these services adequate, and who would pay the costs? 5. Payment for extension of Capital Facilities Indicate how the subdivider will pay for the cost of extending capital facilities resulting from expected impacts directly attributable to the subdivision.