Town of Monroe, NY
Orange County
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Table of Contents
Table of Contents
File No. ______ Amount of Fee $ ______. Date Received ______.
Subdivision Name
Date ______
APPLICATION IS HEREBY MADE to the Town of Monroe Planning Board for a subdivision plat approval for the subdivision described herein.
I.
a.
Applicant's Name
Address
. Tel. No.  _______
b.
If the applicant is a corporation, give the name and title of responsible officer:
Name
Title _____
c.
Land Owner
Owner's Address
d.
Subdivision Engineer or Land Surveyor (licensed):
Name
License No. ______
Address
Tel. No. ______
e.
If the applicant does not own the property, prepare endorsement at the end of this form establishing owner's authorization of the applicant's proposed subdivision of his land.
f.
All communications with regard to this subdivision shall be addressed to the following person until further notice:
Address
Tel. No. ______
II.
Proposed Site
a.
Metes and bounds description of the entire holding, deed restrictions, easements, etc., are attached hereto.
b.
Deed or deeds are recorded in the County Clerk's Office:
Date
Liber
Page
c.
All marsh and water areas and lands subject to periodic or occasional flooding are located on the preliminary layout.
d.
All existing structures are specifically located and described on the preliminary layout.
e.
The proposed subdivision is designed for the following types of land uses:
f.
Do you contemplate any request for a change in zoning? If so, describe the change.
g.
Are all the public open spaces shown on the layout to be dedicated for public use?
h.
How many acres are to be dedicated for public park or playground purposes?
i.
The site will be serviced by the following special districts or utility companies:
Water
Electricity
Gas
Telephone
Others
j.
Will the final plat be filed in sections, or will it cover the entire preliminary layout?
I hereby depose and say that all the above statements and information, and all statements and information contained in the supporting documents and drawings attached hereto, are true.
Sworn before me this
day of _____., 197 __
Applicant's Signature
Notary Public
OWNER'S ENDORSEMENT
COUNTY OF ORANGE
STATE OF NEW YORK
)
)
SS:
_______________ being duly sworn, deposes and says that he resides at
(Owner's Address)
in the County of ______________ and State of
and that he is (the owner in fee) or (Official Title) of the
corporation which is the owner in fee) of the premises described in the foregoing application and that he has authorized _______to make the foregoing application for subdivision plat approval as described herein.
Sworn before me this _________. day of _______, 197__
Owner's Signature
Notary Public
File No.
Date ______
Subdivision Name
Section ______
Chairman
Town of Monroe Planning Board
Monroe, New York
Dear Sir:
     I hereby make application, as subdivider, for Planning Board approval of the subdivision final plat designated above. The information on the original application § A65-34 is still correct unless amended by a revised application attached hereto.
     Further, the following documents, checked below, in proper form for recording, are handed to you herewith:
     Deeds of Dedication for Public Use
     Drainage easement agreements
     Water easement agreements
     Other easement agreements
     Deed restrictions agreements
Subdivider 's signature
By
(used by corporation only)
Title
This schedule is an itemized account of the estimated cost of public improvements to be installed and constructed by the owner pursuant to the Subdivision Regulations of the Town of Monroe Planning Board and the Town Specifications for Public Improvements.
This estimate is prepared by the Town of Monroe Planning Board in seven copies. Four copies shall be made available to the subdivider on the occasion of the review of the final plat. The completed endorsement and resolution shall become the basis for the subdivider's action in obtaining a bond. The bond shall be presented to the Town Attorney at least one week in advance of any Planning Board meeting.
The subdivider shall present letters approving proposed utility installations and a statement as to who will carry out the construction, signed by a responsible official of the utility company which has jurisdiction in the area. Such letters, directed to the Chairman of the Planning Board, shall be received prior to final plat approval.
Name of Subdivision--Sec. No.
Pl. Bd. File No.
Date
ESTIMATE OF COST OF PUBLIC IMPROVEMENTS
Estimate
Estimated Amount of Work
Unit Price
Total
(a)
Grading cu.yds.
$ _____
$ ___
(b)
Paving Type lin. ft. wide
lin. ft. wide
$ _____
$ ___
(c)
Curbing lin. ft.
$ _____
$ ___
(d)
Gutters lin. ft.
$ _____
$ ___
(e)
Sidewalks lin. ft.
$ _____
$ ___
(f)
Stone drain pipe:
$ _____
$ ___
15 in. lin. ft.
$ _____
$ ___
18 in. lin. ft.
$ _____
$ ___
24 in. lin. ft.
$ _____
$ ___
30 in. lin. ft.
$ _____
$ ___
in. lin. ft.
$ _____
$ ___
(g)
Manholes
$ _____
$ ___
(h)
Catch basins - single inlet
$ _____
$ ___
double inlet
$ _____
$ ___
(i)
Planting screen and fence
$ _____
$ ___
lin. ft.
$ _____
$ ___
(j)
Street trees
$ _____
$ ___
(k)
Street signs
$ _____
$ ___
(l)
Monuments in place ............
$ _____
$ ___
(m)
Other (specify) ...............
$ _____
$ ___
TOTAL Cost of Public Improvements
$ ___
ENDORSEMENT:
  It is hereby recommended that the itemized account of cost in the column entitled "Estimate" as totaled should be the amount of the performance bond required by the Town of Monroe for the
Name of Subdivision -- Section No.
and further that the four-percent inspection fee to be deposited prior to final plat approval with the Town Clerk shall be $
Respectfully submitted,
Signed
Town Engineer
PLANNING BOARD RESOLUTION:
The Planning Board adopted the following resolution at a meeting held ________________________
RESOLVED, that the Planning Board Chairman be authorized to sign the Performance Bond Estimate, dated
for
Name of Subdivision -- Section No.
indicating its approval in the amount of $ _______, and further, that the four-percent inspection fee to be deposited prior to final plat approval with the Town Clerk in the amount of $.....
PLANNING BOARD
Chairman
File No.
. Date _______
Subdivision Name
.........................
Section ____________
Chairman
Town of Monroe Planning Board
Monroe, New York
Dear Sir:
This is to advise you that a technical review of the above-designated final plat indicates that the subdivider has completed all the corrections required by the Planning Board resolution dated ______, and further, the subdivider has complied with the provisions of § A65-10F of the Town of Monroe Subdivision Regulations.
Planning Consultant