FOR USE BY LOCAL AUTHORITIES ONLY

Date of Application………………………..

□ Check list Checked by……………………………

Date……………………………………

□ Site Investigation Report Completed by………………………….

Date……………………………………

□ Planning Report Completed by………………………….

Date……………………………………

Zoning
□ Area zoned for proposed use Checked by……………………………
Date……………………………………

□ Area not zoned for proposed use

Regulation requirements

□ Civic number/identify Assigned by…………………………..

Date…………………………………..
 Subdivision Application Form
Information Section
Section 1: Give details of how the site can be located for inspection, if necessary. Provide street name and valuation
number if these exist. If not, provide distance from an outstanding landmark such as milepost, business place, prominent
residence etc., or name of persons who can be contacted locally. Planimetric sheets (1:1250, 1:2500 1:4800, 1:5000,
1:10,000) should be used for sites within an urban area and topographic sheets (1:12,500) for other areas.

Section 2: If the property is not recorded at the tax office in your name, you are considered the agent. If you are applying
as an agent, supply the information for both the landowner and yourself.

Section 3: For residential subdivision of 10 lots and over, open space for community purposes should be provided at the
ratio of one hectare for each 100 lots. If the subdivision is less than 10 lots, write “N/A” in line (d).

(b) i) For Multifamily developments the minimum common amenity area for each unit should be provided as follows:
 Studio
2
- 13.93 m
 1-Bedroom
2
- 27.87 m
 2-Bedrooms & Over
2
- 55.74 m

ii) For parking requirements (see revised Manual for Development, under the Development Standards for Parking)

Section 4: (a) If this is a multi-purpose subdivision the existing and proposed uses for all the lots in the sub-division and
the number of lots to be used for each activity should be stated.

(b) Please see Land Development Classification for details of land uses (available at NEPA and all Local
Planning Authority.)

Section 5: If a package treatment plant will be used as the means of sewage proposal, preliminary approval should first be
obtained from the Ministry of Health (in the Environmental Health Unit). Details of the system should then be
submitted along with this application for final approval. If the proposal is for less than 10 lots, write „N/A‟ in
each of the boxes in lines Section 5 lines (e) and (k).

If „other‟ then details should be given.

Solid Waste Disposal in Section 5 line (i) refers to whether the service of collection is provided for the
community where the sub-division is proposed.
2
Section 6: (a) Recommended minimum lot sizes for residential purposes are 371.609 m (4,000 sq ft) in urban areas and
2
1011.75 m (1/4 acre) in rural areas. Agricultural lots are to be a minimum of 2 hectares (5 acres each), or
that the lot size determined by the Ministry of Agriculture.

(b) Lines (a) and (b) should be completed if a change of land use is contemplated, e.g. from agricultural to
residential. Note: temporary limitations, e.g., unavailability of water for irrigation purposes, will not necessarily
be a reason for removing land from agricultural use.

(c) Supply any other information, which you think will assist in the processing of application. A certified copy of
the original document showing ownership should accompany the application.

Section 7: The selection of an appropriate sewage disposal system for the site depends on the local hydrogeology. The
Resources Authority (WRA) should also be consulted.
 The Application

To ensure the accurate and efficient processing of this application and to avoid delay, supply all the required information.
Fill out all sections completely, supply clear and concise answers based on the opposite page and sign the application.

1. PROPERTY

a) Name of property/subdivision…………………………………………………………………………..
b) Name of City/Town/District/Village……………………………………………………………………..
c) Address and Number of Street (if applicable)………………………………………………………..
d) Name of Parish……………………………………………………………………………………………..
e) Planimetric Sheet No…………………………….. f) Topographic Sheet No……………………...
g) Title Registration: Volume (S)………………….. h) Folio (S)………………………………………..
i) Land Val. No………………………………………..

2. APPLICANT

LAND OWNER AGENT

Name………………………………………. Name………………………………………………
Mailing Address…………………………. Mailing Address…………………………………
……………………………………………… ……………………………………………………..
Tel. No…………Business…………Home Tel. No………………Business………….Home
E Mail Address…………………………… E Mail Address…………………………………..
TRN………………………………………… TRN………………………………………………..

3. SIZE ALLOTMENT

a) Total area of land being subdivided …………………………………………………..hectares/sq.m

b) Lot sizes range from …………………hectares…………….to……………..hectares……………….
or ……………………..sq.m to ………………….. sq.m
c) No. of Lots proposed ………………………………….
d) Total area of open space …………………….H/sq.m

4. USE ALLOTMENT

a) Present Land Use Agricultural Residential Commercial Industrial Institutional

(specify)………………..
Ruinate Farmstead Homestead Recreational Mixed Use Warehouse Other
(specify)………………… Forest………………….. Park/Protected Area
 b) Proposed Land Use Agricultural Residential Commercial Industrial Institutional
(specify)………………..
Ruinate Farmstead Homestead Recreational Mixed Use Warehouse Other
(specify)…………………
c) Indicate Lot Nos. to be used foe each of the above purposes………………………………….
d) Number and use of buildings existing on the land……………………………………………..
e) Covenants which may be breached by proposed subdivision…………………………………
f) Land use on adjoining properties………………………………………………………………

5. AMENITIES AND UTILITIES: (Place an „x‟ in the appropriate box) Existing supply must have capacity to provide
what is needed

a) Electricity Supply: Public Private Not Available

b) Domestic Water Supply: Parish Council Tank Private Tank Private
Reservoir
Public Reservoir Well Other (specify)……
c) Irrigation Water: Available Not available
d) Telephone: Available Not available
e) Sewage: Sewage Main Site Sewage disposal system Package Plant
Septic Tank Tile Field  Other(specify)…...

a) Nearest Education Facilities in km……….Primary………..Secondary………….High…………Tertiary

b) Nearest Health Facilities in km………………………..Hospital…………………………….Health Centre
c) Distance from nearest Town or Village………………………………………………………………………..
d) Solid Waste Disposal Yes If yes, what type ………………………………… No
e) Proposed domestic water supply………………………………………………………………………………
f) Proposed waste water Treatment………………………………………………………………………………

6. STATEMENTS: (If necessary, use additional paper)

a) If lot sizes are below the minimum recommended, state reasons.
………………………………………………………………………………………………………………………..
b) Describe any peculiar or unusual physical characteristics of the property that prevents it from yielding a
reasonable return, if used as is or if it is improved. (See 6b of information section)
………………………………………………………………………………………………………………………..
c) Any other relevant information to clarify proposals
………………………………………………………………………………………………………………………..
 7. I hereby certify that the foregoing information is to the best of my knowledge and belief true and correct.
Please note that false or incorrect information submitted in respect of this application, will disqualify the
application and/or render any approval granted null/void.

____________________________________
Signature: Owner/Agent

____________________________________
Date

FOR THE USE OF LOCAL AUTHORITIES ONLY

1. Date received by the Local Authority……..Information Checked by…………Date checked………..
2. Comments of City Engineer/Supt. Of Roads and Works……………………………………………….
………………………………………………………………………………………………………………
3. Comments of the Fire Dept……………………………………………………………………………….
4. Is Site Inspection report attached Yes No Other Comments………………………..
……………………………………………………………………………………………………………...
5. Date transmitted to NEPA………..
6. Date returned form NEPA…………… Approved Refused
7. Date Presented to the Technical Committee (9 lots and under Applications ONLY)………………..
8. Decision of the Technical Committee (9 lots and under Applications ONLY)……………………….
9. Date presented to the Building & Planning Committee……………………………………………….
10. Decision of the Building and Planning Committee…………………………………………………….
11. Date Conditions were sent to Applicant………………. Date Local Authority received response from
Applicant………………
12. If approved, Date referred to Minister……………………………..
13. Applicant appeals to Ministry Yes No
14. Date dispatched to Minister…………………………………………
15. Decision of Appeals Committee/Minister Confirmed Not supported
16. Date decision received from Minister………………………………
17. Date condition (if approved by Minister) forwarded to him for his dispatch……………………….
18. Date Common Seal of Council affixed on plan……………………
19. Date advice sent to applicant………………………………………

Payment Information
Receipt # ………………….. Amount $................................... Received by …………………….
Date……………………