GROWING COMMUNITY

Case No. ___

APPLICATION FOR MINOR PLAT

1.) Applicant – if owner(s), so state, if agent, tenant or other type of relationship, a letter of authorization must be furnished from the owner(s) with the application. NAME: ___ MAILING ADDRESS: ___ TELEPHONE: ___ OWNER: (CHECK ONE) YES NO

OWNER: (CHECK ONE) ___YES ___NO

2.) Property Location: ___

3.) Legal Description: Lot(s)___ Block(s)___ Subdivision

*Please provide a separate metes and bounds description on a separate sheet.

4.) Existing Use of Property: ___

5.) Zoning: ___

6.) Give a brief explanation of reason for request:

7.) The undersigned hereby requests a minor plat of the above-described property as indicated. Applicant/Agent Date 8.) Owner: ___ Name: ___ Mailing address: ___ Telephone: ___