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55 <br />PROPERTY INFORMATION <br />Parcel # (AKPAR): 141-13 <br />Zoning District: R_ / <br />Flood Map # /VyNr Zone: iJaN'= Watershed District: f�T o <br />S. R. road name: jw_: <br />,Ga <br />Will a Rezoning or Conditional Use Permit be Requested? YES ❑ NO PT- <br />Has Property Been Timbered in Last 5 Years? YES ❑ NO ,% ._ If YES, what year? <br />Is the Property Adjacent to Public Lands (i.e. State, County, Non - Profit or Federal) YES ❑ NO <br />(CIRCLE ALL THAT APPLY) <br />Is the Property Adjacent to any Voluntary Agricultural District(s) YES ❑ NO <br />Environmental Features (Use County GIS [www.chathammis.com] to determine if features are present) <br />Water Bodies (Rivers, Streams, Ponds, Lakes) YES )9� NO ❑ <br />Wetlands YES �" NO ❑ <br />Steep Slopes YES ❑ NO 0 <br />Significant Natural Heritage Area (SNHA) YES ❑ NO <br />Prime Farmland Soils YES ❑ NO <br />Cemeteries YES ❑ NO <br />Other known Historical Features (i.e. structures over 50 years in age) YES NO CI <br />�Iou5r -E- 31 A-2NS <br />Please Attach the Following: <br />Vicinity Map showing the subject property, surrounding area, labels for access roads, and any <br />water bodies on or near the property (available from www.chathamais.com) <br />k List of Adjacent Property Owners (within 400 feet of subject property) for Community Meeting <br />Notifications <br />Draft Concept Plan (minimum 18 "x24" size) – This is a Horizontal plan giving a general overview <br />of suggested layout(s) for development. If more than one plan is offered, it is suggested that at least one <br />be a sustainable development plan with a conservation design incorporating Low Impact Development <br />(LID) options. <br />For Staff Use Only <br />Date Received <br />Date Fee Paid <br />Date Review Completed <br />By <br />Received By <br />Date Applicant Contacted <br />For Questions, Contact Lynn Richardson, Subdivision Administrator (iynn.richardson@chathamnc.ors) or (919) 542 -8207 <br />