Town Of Bellingham Plot Plan Request Form printable pdf download

Town of Bellingham

Plot Plan Request Form

DPW Plot Plan Disclaimer:

•

PLOT PLANS GENERATED BY THE BELLINGHAM DPW ARE NOT SURVEY ACCURATE.

The Town of Bellingham makes no warranties, promises and/or representations, expressed or implied,

relating to the completeness, accuracy, and/or reliability of the data. The data should not be construed as a

substitute for actual field survey and verification.

•

Planimetric Data is from the aerial photographs obtained during a 1994 Flyover all Planimetric items

constructed or modified after 1994 will not appear on the plot plan.

•

The plan will typically show: lot lines, edge of roadway, buildings, fences, walls, driveways, waterways,

and utility poles

I, __________________________________________________________ request a plot plan be printed of the

lot(s) know as ____________________________________________________________________________.

Signed: ________________________________________________________________________

Address: ______________________________________________________________________

City, State, Zip _________________________________________________________________

Phone: _____________________________ Email:_____________________________________

Check One:

[ ] I request that the plan be in AutoCAD format (Version _______) ($30.00)*.

[ ] I request that the plan be in Adobe pdf format letter size ($30.00)*.

[ ] I request that the plan be 8½ x 11 (Letter) paper and do not care about the scale ($20.00).

[ ] I request that the plan be 11 x 17 (Tabloid) paper and do not care about the scale ($30.00).

[ ] I request that the plan be 17 x 22 (ANSI C) paper and do not care about the scale ($40.00).

[ ] I request that the plan be 22 x 34 (ANSI D) paper and do not care about the scale ($50.00).

[ ] I request that the plan be 34 x 44 (ANSI E) paper and do not care about the scale ($60.00).

[ ] I request that the plan be 28 x 40 (ANSI F) paper and do not care about the scale ($70.00).

[ ] I request that the plan be plotted at a scale of one inch equals to _______________Feet.

Cost to be determined prior to plotting.

Check One:

[ ] I will pick up at the DPW when the plan is ready.

[ ] I want the DPW to email the Adobe PDF* or AutoCAD* file to me at the above address.

[ ] I want the DPW to mail the plan to me at the above address via regular mail ($5.00).

[ ] I want the DPW to mail the plan to me at the above address via Us Post Office Priority ($15.00).

[ ] I want the DPW to mail the plan to me at the above address UP Post Office Next Day mail ($30.00).

--------------------------- DPW Section – Do Not Write Below this line ------------------------

Payment of $_______ was received by _________________________________ on __________

Plot plan completed and mailed (emailed) or contact made for pick up on _________________

K:\CAD_SERVER\PDF GIS Maps\Plot Plan Request Form.doc

Town Of Bellingham Plot Plan Request Form