Application for Minor Subdivision

APPLICATION FOR MINOR SUBDIVISION

FINAL PLAT

Department of Environmental Services

Kandiyohi County Zoning

County Office Building, 400 Benson Ave SW, Willmar, MN 56201, 320-231-6229

Version: July 2012

OFFICE USE: Fee $50.00 Date Received _______________ Application Number _____________

Zone _________ Excel __________

Name of Applicant ___________________________________________________________________________

First MI Last

Mailing Address ______________________________City: __________________ State: ______Zip__________

Tax Parcel Number ______________________________ Daytime Phone ______________________________

Property Address____________________________________________________________________________

Lake: _______________________________ Township _____________________________ Section _________

Legal Description ____________________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________

NAME OF MINOR SUBDIVISION: ________________________________________ Total Number of Lots: ______

I hereby certify that I have examined this application and acknowledge the information submitted to be true. I further agree there shall be no changes in plans or specifications to the work authorized herein unless such change is first approved in writing by the zoning administrator. The approval of this proposal does not negate the need to secure other permits from other local units of government, state agencies or federal agencies who may also have jurisdiction over portions of your project.

Signature of Applicant _____________________________________________ Date__________________________

The Minor Subdivision Final Plat is hereby approved to be recorded within the office of the County Recorder within 180 days after the date of approval, otherwise the approval shall be considered void. The Minor Subdivision Final Plat is approved under existing regulations for zoning compliance, and upon the following conditions __________________________________________________

___________________________________________________________________________________________________________.

Zoning Administrator ______________________________________________ Date __________________________