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-15494010668000CLASS A, CLASS B, &RE-SUBDIVISION APPLICATIONCLEARWATER COUNTY BUILDING & PLANNING150 Michigan Ave ● PO Box 586 ● Orofino, ID 83544Office (208) 476-4815 ● Fax (208) 476-8994 bp@ ● General Information:Applicant Name: FORMTEXT ?????Contact Number (s): FORMTEXT ?????Mailing Address: FORMTEXT ?????City: FORMTEXT ?????State: FORMTEXT ?????Zip Code: FORMTEXT ?????Email Address/Fax Number: FORMTEXT ?????Property Owner Name (if different than applicant): FORMTEXT ?????Contact Number (s): FORMTEXT ?????Mailing Address: FORMTEXT ?????City: FORMTEXT ?????State: FORMTEXT ?????Zip Code: FORMTEXT ?????Parcel Information:On the County Homepage click on the County Map/Planning Tab to look up your parcel and tax information. Use the Map Layers for determining zoning, floodplain, and planning areas.Parcel Identifier/Tax ID: FORMTEXT ?????Section: FORMTEXT ?????Township: FORMTEXT ?????Range: FORMTEXT ?????Property/Site Address: FORMTEXT ?????City, State, Zip Code: FORMDROPDOWN Directions: FORMTEXT ?????Is parcel located within a platted subdivision? FORMCHECKBOX No FORMCHECKBOX Yes: Name: FORMTEXT ?????Within an Area of City Impact? FORMCHECKBOX No FORMCHECKBOX Yes: FORMCHECKBOX Orofino FORMCHECKBOX Weippe FORMCHECKBOX Pierce FORMCHECKBOX Elk RiverIs the property located in a fire district: FORMCHECKBOX No FORMCHECKBOX Yes*If yes, district name: FORMDROPDOWN Is the property located in a floodplain: FORMCHECKBOX No FORMCHECKBOX Yes*If yes, zone: FORMTEXT ????? FIRM Panel Number: FORMTEXT ?????*You need to contact your local fire chief for any additional requirements they may have.*Flood Insurance Rate Maps are available at the courthouse or on FEMA’s website. An elevation certificate maybe needed.Located within Joint School District: FORMCHECKBOX Orofino #171 FORMCHECKBOX Kendrick #283 FORMCHECKBOX Nezperce #302 FORMCHECKBOX Whitepine #288Existing Land Use: FORMCHECKBOX Residential FORMCHECKBOX Commercial FORMCHECKBOX Ag/Timber FORMCHECKBOX Undeveloped/RecreationalZoning District: FORMDROPDOWN Total Acreage: FORMTEXT ?????Any liens/taxes owed on the property: FORMCHECKBOX No FORMCHECKBOX YesType of Water: FORMCHECKBOX None FORMCHECKBOX Private FORMCHECKBOX Shared well (non-public) FORMCHECKBOX Public; name: FORMTEXT ?????Type of sewage disposal system: FORMCHECKBOX None FORMCHECKBOX Individual Septic FORMCHECKBOX Municipal Sewer; name: FORMTEXT ?????Subdivision Proposal InformationTotal Number of Lots: FORMCHECKBOX Class A: Over 10 lots FORMCHECKBOX Class B: 4-10 lots FORMCHECKBOX Re-subdivision Total Number of Lots: FORMTEXT ?????Lot Sizes (acres/square feet): FORMTEXT ?????- FORMTEXT ?????MINIMUM LOT DIMENSIONAL REQUIREMENTS AS ESTABLISHED BY ZONING DISTRICTSZoneF-1F-2, R-3R-1, R-2, C-1/-2, M-1/-2Width & Depth250 x 250 ft150 x 150 ft75 x 75 ftArea5 acres1 acre7,500 sq ftWill the proposed lots meet the minimum lot dimensional requirements per zoning? FORMCHECKBOX Yes FORMCHECKBOX No; a variance is neededProposed Land Use: FORMCHECKBOX Residential FORMCHECKBOX Non-residential FORMCHECKBOX Recreational FORMCHECKBOX Other: FORMTEXT ?????Type of Water: FORMCHECKBOX Private FORMCHECKBOX Shared well (non-public) FORMCHECKBOX Public; name: FORMTEXT ?????Type of sewage disposal system: FORMCHECKBOX Individual Septic FORMCHECKBOX Municipal Sewer; name: FORMTEXT ?????How will these parcels be accessed? (Name all public and private roads involved.) FORMTEXT ????? FORMTEXT ?????Are there or will there be easements and/or right-of ways involved with accessing these parcels? If so, how wide is the easement? Proof of easement is required. FORMTEXT ????? FORMTEXT ?????Proposed Name of Subdivision; can not be the same name as any previously recorded platted subdivisions within Clearwater County: FORMTEXT ?????Required Documents in addition to the application include: FORMCHECKBOX The most current Deed for the property (This information is available in the Auditor Recorder’s Office.) FORMCHECKBOX If needed, site evaluation or letter from the Public Health Idaho North Central District Health Department (208) 476-7850 located at 105 115th Street, Orofino, ID 83544 . FORMCHECKBOX Survey demonstrating the requested subdivision which shows the minimum: FORMCHECKBOX Lot size & dimensions FORMCHECKBOX Scale FORMCHECKBOX Access and width of roads/easements/driveways FORMCHECKBOX North ArrowSurveys are to be prepared by a license professional and in accordance with Idaho Code. FORMCHECKBOX Re-Subdivision-Copy of Original Recorded Plat (Available from the County Auditor Recorder’s Office). FORMCHECKBOX If a new access road or driveway which requires an approach to a County Road or Highway is going to be constructed, please contact the County Road and Bridge Department at (208) 476-4813 or the Clearwater Highway District at (208) 435-8002 for further information and requirements.FEES- PLANNING DEPARTMENT USE ONLYMake payment to Clearwater County. Credit cards are allowed with an additional cost for processing. FORMCHECKBOX Class A & B-Preliminary Subdivisions $500 + $25 per lot FORMCHECKBOX Class A & B-Final Subdivision $500 + $25 per lot FORMCHECKBOX Re-Subdivision $250 + $25 per lotTotal permit fee: $ FORMTEXT ?????COMPLETED APPLICATIONS MUST BE SUBMITTED BY 2:00pm ON THE REQUIRED DUE DATE.Any uncompleted applications will not be accepted.APPLICANT: Read and sign. I declare that all statements I have made on this application are true and correct to the best of my knowledge. I understand that additional documentation may be requested as a part of this agreement. I understand that falsification of this application for the purpose of evading land use laws adopted by county ordinances is a misdemeanor. I understand that the granting of this permit does not give authority to violate any provisions of state or local laws, and that all governing ordinances will be obeyed.Applicant’s Name:(please print) FORMTEXT ?????Title: FORMTEXT ?????Applicant’s Signature:Date: FORMTEXT ????? ................
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