Land Division Application Form
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1
2Assessor’s Office
323 W. Michigan Ave.
Marshall, MI 49068
LAND DIVISION APPLICATION
(269) 781.5183
Applicant’s Name __________________________
Owner’s Name ____________________________
Address _________________________________
Address _________________________________
_________________________________
_________________________________
Phone _________________________________
Phone _________________________________
Location of Parent (primary) Parcel: __________________________ Parcel # ________________________
Number of child (new proposed) parcels: ______________ Proposed use: ___________________________
Current zoning of land: ____________________________
Will each new parcel have access to a public street?
Yes
No
Will a new roadway be created?
Yes
No
If yes, please include engineered drawings and legal description for proposed road.
Any existing or proposed easements on the parent parcel?
Yes
No
If new easements are proposed, please include engineered drawings and legal description.
Are future divisions allowed but not included in this application?
Yes
No
Are any future divisions being transferred from the parent parcel to another parcel?
Yes
No
If yes, which parcel(s)? _____________________________
Do any of the following situations exist on the parcel to be divided?
Flood plain
Wetlands
Severe soil limitations
Underground tanks
Contaminated soils
Abandoned well
The following items must be attached to this application:
Full legal property description and proposed descriptions
Legal survey, sealed by a professional surveyor, of the proposed division(s)
AFFIDAVIT and PERMISSION for City officials to enter the property for inspections:
I agree the statements made above are true, and if found not to be true, this application and any approval will be void. Further,
I agree to comply with the conditions and regulations provided with this parent parcel division. Further, I give permission for officials of
the City to enter the property where this parcel division is proposed for purposes of inspection to verify that the information on the
application is correct at a time mutually agreed with the applicant. Finally, I understand this is only a parcel division which conveys only
certain rights under the applicable local land division ordinance, the local zoning ordinance, and the State Land Division Act (formerly the
Subdivision Control Act, 1967 P.A. 288, as amended) and does not include any representation of conveyance of rights in other statute,
building code, zoning ordinance, deed restriction or other property rights.
Property Owner’s Signature ______________________________ Date ____________________________
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