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.•{ PLEASE TYPE OR PRINT ( INK ONLY) <br /> 6/E7 <br /> APO, i^ArION FOR StBDIV ! S ION AapRCyAI 3 <br /> 0 . . RA -4C Ins . <br /> �lA BATE <br /> SUBDIVISION NAME: �`�="f��,�► •L �; �1i � 'G/I /0// <br /> LOCATION: n.17— <br /> / S/N/4/ /474)/F0( <br /> OWNER/DEVELOPER: o/k'►/9S/•�E vsc_ i <br /> ADDRESS: / f os TELEPHONE NO. : <br /> AGENT/CONTACT: 0/ ERR TELEPHONE NO. : 4 7 7`675e� <br /> KOLA *++twD) NzC.7S7 Z <br /> A. SUMMARY INFORMATION:pN: <br /> Orange County Tax Map,' <br /> ap Block Lot( s <br /> ) 17 Townsh i pLs#4 L EILL <br /> Zoning Distrlct( s) : Jef0Qrr_ <br /> Total Number of Acres: <br /> Phases: <br /> Total Number of Lots:_2_Avereoe Lot Size:, Minimum Lot Size_ <br /> Number/Type of Structures; ( ex i st I ng), O.1/E .( proposed) 4. X/S f/n•+ E <br /> Lineal Feet 1 n Streets: NoAug- Acres in Open Space /040z t% P4ASQif[ <br /> Water Supply: Public ( specify) Community Individual fc �Q a/tvE•��,o <br /> Wastewater Disposal : Publ1 ( specify) Community individual 7 <br /> School District: A// e.eOG A Fyr.e District: /V¢1J ""7•.t. <br /> General Land Uses In Area: S r•75.9i <br /> Critical Areas: stream/dreinageways flood prone areas <br /> watershed ( specify) historic sites <br /> other (explain) ,Y " L <br /> Ill B. All plats must be submitted on sheet no smaller than one inch equals <br /> two-hundred feet ( 1"=200' ) and no larger than one Inch equals fifty <br /> feet ( 1 "w501 ) and must contain the following information: <br /> ,••• subdlvlsiDn nave /�•••�•. <br /> z7ri name vi ownerlsi • building setpeck lines <br /> by notation or ?Weal lot <br /> :••.-••• name of surveyor, •- •• 1 pyoui <br /> engineer Or lend : exl5ling and proposed <br /> 1.7planner eesemen,s (drelnega. <br /> ': _ (Title) Preliminary /•:..••.:•• <br /> Plan utilities. ropes, e,e•) <br /> v '• r. existing, proposed and <br /> -:}:• "i:. scale, north arrow <br /> U.Ortn at top of mop) adjoining rights-of-way <br /> �::.•e InCluding dimensions and <br /> 1! : date ( Including strait nOmOi and state <br /> • revision Oates) :••:�:• road numbers <br /> Tornihlp, taA map- 041A4,. ]: -:: . <br /> ,Jf, b I oCk•l oT reterenCOS +::•: ex 1 it 1 ng and proposed <br /> _ • • bounder utilities, Including type, <br /> .-`Yr y described •••:•::•:•• sites. by , velvet <br /> ::::::: with bearings sac :'-:':ti' mennoles <br /> 7- di / ;..;;;•.. axis/log and proposed <br /> : : Tote1 ge of the _ Culvert Including sites <br /> C ?r.ct and aeraege of - end grapes <br /> G lots. Including and /� -•+'i+gr:: <br /> •scludln area within "': TyblCal tripe, Cross- <br /> r1ghT g ey t•::* sectIOns inc (...rime/1On <br /> .n s-of-r _ Details Including design <br /> Control and width of tr v <br /> ''-'••{• prapo..d lot limes • elrey <br /> y� w with dimensions �� ,''--•�'�'•.••;:: end shoulders <br /> E w lot numbers Y: general Cl alignment ubd <br /> y ;: }}:: general Curv■ Oef■ (publ IC <br /> yr 7 Phasing lines <br /> ropes) <br /> ... O f.� - topography aT ten teat ::4;: parmanen, features such as <br /> ID (10) 1 is bulldings. les. <br /> i N :: bodies. streams, / : :: ;;e t: h I stpr l c l endmarKs <br /> W 0 floodr L/ i�r <br /> �, ,, '' ay and f I ood- x.ii4: adjoining id 1 ayoYt names <br /> Q) plains <br /> Of adjoining property <br /> EM stream buffers rnd ::...a* owners and subdivisions <br /> N netetlon Indicating <br /> o ro <br /> ` •••� restricted Cevelopasat <br /> U 4 potential <br />/11 -Y 0.) <br /> ;ra;: It.. Corborate en0 -Territorial planning jurisdlC- <br /> �/� :: .ion lines which CrOSS the property <br /> IL co <br /> location and site of parcels cadicated for public use or <br /> N L ::••:;-::: reserved I n common <br /> i ti7 L .. . I0Cet1011 end sltt of lots of restricted development potential <br /> N/a and notation on ;let regarding seine <br /> L stormreTer management plan indicating provision for control <br /> -} Of the firs, 1/2 Inch of runoff from Impervious surfaces <br /> please complete reverse side <br />