SPLIT / COMBINE REQUEST HISTORY
ACTION
REQUESTED ______SPLIT ______COMBINE
SIDWELL
NUMBER(S): 17-_________________________17-_____________________
PROPERTY
OWNER SIGNATURE:
_______________________________________________
SUBMITTED
BY: ___________________________________________________
ADDRESS: ___________________________________________________
___________________________________________________
PHONE
NO#: (_____)_______________________(____)_________________
PRELIMINARY
SKETCH
SUBMITTAL
DATE: ___________________
PROPERTY
SERVED BY _____WATER _____SEWER
______SEPTIC ______WELL
COMMENTS
ON PRELIMINARY SKETCH & RECOMMENDATIONS: K.J.P.____ .____
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
SURVEY
OR FINAL DRAWING
SUBMITTAL
DATE: ________________________ K.J.P._______._______
ACTION
BY TOWNSHIP: ___________________________________________________
_____________________________________________________________________________
DATE: __________________
PLEASE
INDICATE THE NAMES AND ADDRESSES YOU WOULD LIKE ON THE TAX ROLL
FOR
EACH PARCEL:
NO.
1 (A) NO.
2 (B) NO.
3 (C)
NAME NAME NAME
NOTE !!!!!! Approval
of this split request does not indicate these sites as buildable, nor negate
the need for approval from other agency’s.
Article II of the
Oakland County Sanitary Code effects lot size and any request to build needs
Oakland County Health Dept. approval or public sewers.