Appendix A
Date ____/____/_______
Current Property Owner: ________________________________________________
New Property Owner(s) [if known]:___________________________________________
Parcel ID# ______________________________________________________________
Property 911 Address: _____________________________________________________
Size of Parent Parcel: _____________________________________________________
Sizes of Subdivided Parcels: ________________________________________________
________________________________________________
Reason for Subdivision: ____________________________________________________
____________________________________________________
Please include a detailed plot plan as described in Article VI, Section 1.
If the purpose for subdivision is for the installation of additional residential quarters, a perk test and a detailed map of the septic system layout will be required. Details must include locations of all sources of water (i.e. Wells, lakes, streams, rivers, etc.), slope of land, and all distances drawn to scale. Please note that slopes greater than 15 degrees increase separation distances from 100 to 200 feet.
