SUBDIVISION APPLICATION

FOR THE

TOWN OF SUMNER

SUBDIVISION NAME: ______________________________________________________

APPLICATION NUMBER: ___________

APPLICATION INFORMATION

1. Name of Property Owner: __________________________________________________

Address: __________________________________________________

__________________________________________________

2. Name of Applicant: _______________________________________________________

Address: _______________________________________________________

_______________________________________________________

Telephone: _______________________________________________________

5. If Applicant is a corporation, check if licensed in Maine__yes,__no

If yes, attach copy Secretary of State's Registration.

4. Name and address of applicant's authorized representative:

__________________________________________________

Telephone: _____________________________

5. Name, address and number of Registered Professional Engineer, Land Surveyor

or Planner who prepared the plan:

__________________________________________________

Telephone: (____)____-_______ Registration #___________________

SUBDIVISION APPLICATION

FOR THE

TOWN OF SUMNER

6. Person and address to which all correspondence from the Planning Board should be sent:

__________________________________________________

7. What interest does the Applicant have in the parcel to be subdivided?

(option, land purchase contract, recorded ownership, etc.)

8. What interest does the Applicant have in any property abutting the parcel to be subdivided?

9. State whether the subdivision covers entire or contiguous holdings of the Applicant.

SUBDIVISION APPLICATION

FOR THE

TOWN OF SUMNER

LAND INFORMATION

10. Location of property: (from tax maps) Map____ Lot (s)

11. Location of property: (from Registry of Deeds) Book____ Page____

12. Current zoning of property.

15. Acreage of parcel to be subdivided.

14. Proposed method of sewage disposal and the results of an on-site soils investigation for each lot.

15. Soils report for entire area. (Please include with application, if requested by Board)

16. List below names and addresses of property owners within 500 feet of the parcel to be subdivided.

NAME ADDRESS

______________________________________________________________________

17. Indicate the nature of any restrictive covenants to be placed on the deeds.

18. Include a statement of financial and technical capability.

19. Has this land been part of a prior approved subdivision?__yes,__no

Or other division within the past 5 years?__yes,__no

To the best of my knowledge, all the above stated information in this application is true and correct.

Signature of Applicant:______________________________________________________

Date:__________________________________