Application For Land Division And/or Boundary Adjustment Page 3
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4_____ 1. Survey drawn to scale, showing (attach & label accordingly)
____ a)
current boundaries of original parent parcel
____ b)
all previous divisions made from original parent parcel
____ c)
proposed division(s)
____ d)
dimensions of the proposed divisions
____ e)
existing and proposed road/easement rights-of-way
____ f)
existing and proposed public utilities which provide service to the
parcel
____ g)
any existing improvements (buildings, wells, septic system,
driveways, etc. including setback requirements
____ h)
legal description of all divisions and remainder of parent parcel
____ i)
wetlands
____ j)
flood plains
____ k)
underground storage tanks, contaminated soils
____ l)
existing topography and proposed preliminary drainage plans
_____ 2. Certification that boundary corner monuments have been or will be placed.
I agree the aforementioned statements made are true, and if found not to be true, this application
and any approval shall be void. Further, I agree to comply with the conditions and regulations
provided with this parcel division. In addition, I agree to give permission for the officials of the
City of Traverse City, Grand Traverse County, and/or the State of Michigan to enter, during
reasonable work hours, the property where this parcel is proposed for purposes of inspection.
Finally, I understand this is only a parcel division which conveys certain rights under the
applicable local land division ordinance and the State Land Division Act (formerly the
subdivision control act P.A. 288 of 1967, as amended (particularly by PA. 591 of 1996), MCL
560.101 et.Seq.) and does not include any representation or conveyance of rights in any other
statute, building code, zoning ordinance, deed restrictions or other property rights.
Lastly, even if this division is approved, a land division does not occur until receipt of a
registerable conveyance is supplied to the City of Traverse City. I understand if zoning, local
ordinances and State Acts change prior to land divisions being completed (registerable
conveyances) the divisions must comply with the new requirements unless deeds, land contracts,
leases or surveys representing the approved divisions are recorded with the Register of Deeds. I
further understand that this approval is valid for six months from the date of issuance and if the
proposed land division is not completed during the six month time frame, a new application and
approval must be obtained.
The applicant acknowledges that the City may be required from time to time to release
records in its possession. The applicant hereby gives permission to the City to release any
records or materials received by the City from the applicant as it may be requested to do so
as permitted by the Freedom of Information Act, MCL 15.231 et seq.
Please attach the appropriate $310.00 per application fee
K:/tcclerk/landdivisionforms/land division boundary adjustment application.doc
Last Updated: February 25, 2014
Page 3 of 4
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