Application For Subdivision Or Land Development - Northumberland County
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1
2NORTHUMBERLAND COUNTY
Return to: Northumberland County Planning Commission
399 South Fifth Street, Suite 207
APPLICATION FOR SUBDIVISION
Sunbury, PA 17801
OR LAND DEVELOPMENT
Phone 570-988-4220
Fax
570-988-4436
SUBJECT: Request for review of a subdivision or Land
TO BE COMPLETED BY STAFF
Development under the Northumberland County
Subdivision and Land Development Ordinance. This
DATE OF SUBMISSION: _______
DOP:_____________
Application must be completed by the Applicant and
submitted to the above address, along with a
REQUIRED FEE: _______________________________
minimum of six (6) sets of plans, accompanying
documents and the required fee (see reverse
NUMBER OF PLANS SUBMITTED: ________________
side).
TO BE COMPLETED BY APPLICANT
Development Name (if applicable): _____________________________ Municipality: ____________________
Owner’s Name: ____________________________________________ Phone: ________________________
Owner’s Address: __________________________________________________________________________
Applicant’s Name: __________________________________________ Phone: ________________________
Applicant’s Address: ________________________________________________________________________
Architect/Engineer/Surveyor’s Name: ___________________________________________________________
Address: ___________________________________________Phone: _______________________________
Site Location Address _______________________________________________________________________
TYPE OF REVIEW REQUESTED
TYPE OF PLAN
MUNICIPALITY
Unofficial Sketch
Minor Subdivision – 5 lots or less
Was plan submitted to the
Preliminary
Major Subdivision
municipality :
Final
Add-on Subdivision
Land Development
Y_____
N_____
PLAN INFORMATION
PROPOSED LAND USE / # OF LOTS
PROPOSED UTILITIES
(check appropriate boxes)
Agriculture
____
Total Area (gross acres): _________
Single Family
____
Water
Sewer
Townhouses
____
Acreage of Residual: ____________
Twin Units
____
Public/
Apartments
____
Ownership of Roads:
Community
Mobile Homes
____
Public
Private
Commercial
____
On-site
Industrial
____
Located in Floodway or Floodplain:
Institutional
____
Yes
No
New sewage disposal or
Other __________
____
water supply proposed
Y____
N_____
Erosion/Sedimentation Control Plan:
Submitted
Not Applicable
HOP
Y____ N____
Sewage Planning
Pennsylvania Department of Environmental Protection
(Supporting Documentation Must Be Attached)
DEP Approval Letter
DEP Request For Planning Waiver and Non-Building Declaration
NOTE: No Plan Will Be Accepted Without The Sewage Planning Portion Completed
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