-- COMPLETE THIS PAGE FOR SUBDIVISION APPLICATIONS --

1. Name of subdivision. _______________________________________________________________

2. Complete legal description of subject property. ___________________________________________

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3. Subdivision size: __________ Acres __________ Lots _________Blocks __________Av Sq ft/lot

4. Please give a brief description of the proposed subdivision. __________________________________

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5.Please give a brief description of the anticipated public improvements associated with this subdivision.

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6. Estimated cost of public improvements. _______________________________________________

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7. Names, addresses and phone numbers of owners of lands to be subdivided (if more than shown on the first page of this application).

Name ______________________ Address _________________________ Phone __________

Name ______________________ Address _________________________ Phone __________

Name ______________________ Address _________________________ Phone __________

Name ______________________ Address _________________________ Phone __________