TOWN OF WAVERLY, ALABAMA SUBDIVISION APPLICATION  Property ownersi int the Town of Waverlyw who wisht tos subdivide property within the Town and within the Town'se extraterritorial planning. jurisdiction: must complete a Subdivision Application: form. To request Planning Commission approval ofay proposed subdivisionplan,; please complete thei following application: andi return thei formwitha allnecessary: supporting documents to Town  Hall. Incomplete applications willi not be processed. For additional information, please call the  Enforcement  Officer at (334)887-6453 during regular business hours.  TownofWaverly:  Applicant) Information:  Name ofApplicant: Mailing Address:  Business Hours Telephone #: L Fax#( (Ifavailable): L NOTE:  Ifthe applicant is NOT the owner of the subject property, then the application MUST be accompanied by a letter signed by the owner authorizing the applicant  tos submit the application.  Consulting Engineer Information: (Ifs same as applicant, complete only first three lines)  Name of Lead Consultant: Name of Consulting Firm: Professional Trade. Affiliation: Mailing Address:  - Engineer  Surveyor  Architect  Business Hours Telephone #: L Fax# #Ifavailable): L  67    Property Summary Information: Owner(s) ofRecord:  Street Address of Subject Property:  IsSubject. Property Located Within the Town Limits of Waverly? I Yes  ]No  Tax Map & Lot Number ofSubject. Property: Zoning Classification ofSubject. Property: Size of Subject Property in Acres: Size in Acres ofSmallest Lot to be Created: Total Number ofNew. Lots to be Created:  IsS Subject Property Located Within 300. Feet ofa Town Water or Sewer Main?  ]Yes  INo  Uses to be Allowed in Subdivision: [ Residential I Industrial I Commercial  Is Property Located Within a 100-Year Floodplain?  ]Kes  No  Supporting Information:  Please submit thej following items with the Subdivision Application form:  II Full payment of fthe required. Application Fee.  II Six prints or copies of, a preliminary plat of the proposed subdivision satisfying all requirements ofArticle V,S Section 4.3of the Waverly Subdivision Regulations. II Alisting ofthe names and mailing addresses ofal! owners ofland immediately adjoining the proposed: subdivision, property as theirnames may appear upon the plats contained in the County Tax Assessor's office and as their addresses appear in the directory of the [I A complete list of all local, state, and federal permits or approvals that have been applied for or secured by the applicant) for the proposed subdivision as ofthe date offiling ofthis  municipality or on the tax records of the municipality or county.  application.  68    Certifications:  Applicant:  Ih hereby certify and attest that, to the best of my knowledge and abilities, the information provided in this application is true and accurate. Further, I agree to provide any additional information within my powers that may be required by the Enforcement Officer, Town Engineer, or Planning Commission to determine the compliance of the proposed property construction or improvement activities with the Subdivision Regulations and Zoning Ordinance of the Town of Waverly.  Date Property Owner:  Applicant's Signature  Ih hereby certify and attest that, to the best of my knowledge and abilities, the information provided in this application is true and accurate. Further, I agree to provide any additional information within my powers that may be required by the Enforcement Officer, Town Engineer, or Planning Commission to determine the compliance of the proposed property construction or improvement activities with the Subdivision Regulations and Zoning Ordinance of the Town of Waverly.  Date  Property Owner's Signature  69    FOR TOWN OF WAVERLY USE ONLY  Enforcement Officer's Information:  Date. Filed: Received. By:  Application Fee Received: S Date Reviewed and Deemed Complete: Enforcement Officer'ss Signature: Public Hearing Date:  Cash  ICheck #.  Date Public. Hearing was Closed (if Different from Above):  Planning Commission Action on. Preliminary Plat: - Approved  Denied  Date of Final Action by Planning Commission:  Planning Commission Findings and/or Special Conditions of Approval:  Planning Commission Chair'sSignature:  1  70