Moore Township Planning Commission 2491 Community Drive, Bath, Pennsylvania Telephone: FAX: Rev:12/23/2013

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2491 Community Drive, Bath, Pennsylvania Telephone: 610-759-9449 FAX: 610-759-9448 Rev:12/23/2013 APPLICATION FORM FOR A SITE PLAN PER MOORE TOWNSHIP ZONING ORDINANCE SECTION 200-58.1 NORTHAMPTON COUNTY, PA. Date: APPLICATION FEE SCHEDULE: Application Fee: Engineering Escrow Fee: $ 200.00 $ 1,000.00 The following items need to be included with the completed Subdivision Application: The complete Tax Parcel Number:. A copy of the actual deed for the property affected. A Transmittal Form or letter explaining the full contents of the submission. One (1) copy of a completed and signed Consent Form. Three (3) copies of the completed Sewage Planning Module Forms. If Three (3) copies of the completed Storm Water Calculation Forms. Applicable Fifteen (15) copies of the Site Plan folded to 9"x12" size. Fifteen (15) copies of a reduced 11"x17" Site Plan. A check payable to Moore Township for the required Application fee, see above. A check payable to Moore Township for the required Engineering Escrow fee, see above. In addition, complete the following: 1. Proposed name of Project: Zoning District:, Block:, PIN:. 2. Owner: Applicant: ; (If Applicant is different than owner both Owner & Applicant must sign application.) Page 1 of 10

Telephone: FAX (if any): Address: ; Owner: Agent: ; Other (explain): 3. Licensed land surveyor or professional engineer: Address: Telephone: 4. Location of proposed subdivision, Use, Land Development: 5. Easements or other restrictions on property (describe generally): 6. Names of abutting land owners (include those across adjoining streets): 7. Per Section 200.58.1 of the Moore Township Zoning Ordinance, a complete narrative explaining in detail all of information required pertaining to the proposed use or structure: (Attach additional sheets if necessary) Page 2 of 10

8. The undersigned hereby request recommendation by the Moore Township Planning Commission to the Moore Township Board of Supervisors of the above site plan. Signature: Owner Signature: Applicant Date: Telephone: Page 3 of 10

Article 200-58.1 Site Plan Review A. It is the purpose of this procedure to enable the Township Planning Commission and Township Board of Supervisors to review the site plans of an applicant to assure that they meet the stated objectives and standards of these regulations, conform to the stated objectives of other agencies, provide for the safety and convenience of the general public, as well as those using the subject site, and preserve important site features and landscaping where desirable. B. Procedure: (1) In all cases where these regulations require approval of a site plan, a zoning permit shall not be issued until after the Planning Commission and Township Board of Supervisors have reviewed the site plan in accordance with the procedures set forth in this chapter and until the Township Board of Supervisors has approved the site plan. Permits shall be issued only in conformity with the approved site plan. (2) The Zoning Office shall submit the site plan and supporting documents to the Township Planning Commission and other required review agencies within 10 days of the receipt of the site plan. (3) The Planning Commission may refer applications for the site plan review to other appropriate agencies and authorities for review and recommendations. (4) The Planning Commission and Township Board of Supervisors shall have a total of 90 days from the date of the first regular Planning Commission meeting after the submission of the application, according to the same time requirements allowed for subdivision and land development plan submissions and reviews under the Pennsylvania Municipalities Planning Code, Act 247, as amended (53 PS. 10101 et seq.), unless an extension of time is granted by the applicant. C. Applicant requirements. (1) Applicant for site plan review shall be submitted to the Zoning Officer, Fifteen copies of all plans certified by a registered architect, engineer, or surveyor shall be submitted, along with the site plan review fee, as established by resolution of Township Board of Supervisors, to cover the additional expense of reviewing said site plan. Any request for a waiver from any provision of this site plan requirements shall be made to the Board of Supervisors, along with a fee for such request as established by resolution. (2) The site plan shall include, as a minimum, all the following information, except that these requirements may be modified by the Planning Commission to reflect the information needed to review adequately the plans for the intended use: Page 4 of 10

(a) Location of the site, drawn to a scale of not less than one inch equals 50 feet, showing abutting streets, nearest cross streets, driveways to adjacent lots, structures on adjacent lots which are less than 100 feet from the property line, dimensions and size of the lot. (b) Streets and property lines, curbs, pavement sidewalks, easements, and rights-ofway. (c) Locations and dimensions of all existing and proposed buildings, structures, walls, fences, utility buildings, existing trees of eight-inch caliper or more at four feet above the ground and other significant landscape elements. (d) Existing and proposed contours, at maximum two-foot intervals, and limit of earth disturbance. (e) Location of all existing watercourses, wetlands, drainageways, floodplain limits, and rock outcroppings, cliffs, quarries, and woodlands. Also, the location of any carbonate geology features that might pertain to the site. (f) Zoning data for all proposed buildings, structures or uses, including height, number of stories, yards, building coverage, number of parking spaces, number of dwelling units, total building area and proposed uses. Also, zoning calculations of slope, woodland cover, floodplain, wetlands, rock outcrop, cliff and quarry areas with associated calculations of required adjusted lot size development density or cover requirements. (g) The title of the development, date, revision dales, North arrow, scale, name and address of owner, name and address of equitable owner (if applicable) and name and address of applicant, if different from owner or equitable owner, and signature of the applicant and the owner with a statement indicating their approval of the plan. (h) Location and dimensions and proposed surfacing of existing and proposed offstreet parking and loading spaces, traffic access circulation drives and pedestrian walks and projected volumes of vehicle and pedestrian traffic using the site. (i) Location, size, and type of proposed landscaping and buffer planting and the designation of those areas of natural vegetation not to be disturbed. (j) Location, type, design, shielding, and hours of operation of all existing and proposed exterior, parking lot and garage lighting. (k) Description and elevation view of all proposed structures. (l) Location, type, size, design, color and illumination of all signs. (m) Location and description of water supply, fire protection system, sewage facilities and stormwater management facilities and supporting calculations. Page 5 of 10

(n) Location of building or structure listed in or eligible for the National Register of Historic Sites and estimated date of construction of all existing buildings and structures. (o) A project narrative providing the following information: (1) Proposed use. (2) Hours of use. (3) Description of product produced, services provided or goods sold and process or methods used in providing these services. (4) Number and job classifications of employees. (5) A plan for providing emergency services, including police, health, and fire. (6) A list of chemicals to be used or stored on the property in any quantity in excess of 20 cubic feet in volume, except: (a) Chemicals, such as heating oil or propane, which may be required for the normal heating and cooling of a building or fire-suppression chemicals. (b) Printing supplies, photographic developing chemicals and janitorial chemicals and lawn and agricultural fertilizers in a quantity not to exceed 40 cubic feet. (c) Aboveground tanks for storage of fuel oil for use by the property owner for: (i) Farm-related equipment; (ii) Trucks or automobiles; and/or (iii) Emergency equipment or vehicles. (7) The results of test borings which denote ground stability. (p) Certification that utilities to be provided are adequate for the intended use. (q) The copy of all required permits and supporting documents required by federal, state, and local government agencies. (r) In the case of on-lot sewage disposal, the locations and elevations of all passing and failing soil test trenches and percolation tests and proposed primary and replacement drainfield areas and all soil test results. Page 6 of 10

(s) Location, type and design of proposed soil erosion and sedimentation control devices, with appropriate narrative, and approval from the Soil and Water Conservation District of said plan. (t) A traffic impact study for all proposed land uses expecting to generate 250 vehicles per day of traffic. Ingress is one count and egress is one count. E. Standards for review. In reviewing site plans, the Planning Commission and Township Board of Supervisors shall take into consideration the purposes of these regulations, including the purposes of the applicable zoning district and the safety and convenience of the general public. Site plans may be modified and conditions put on approvals when deemed necessary to meet the following objectives: (1) Safe, adequate and convenient vehicular and pedestrian traffic both within and without the site. The Planning Commission and Township Board of Supervisors shall take into consideration the following features: (a) Number, location, and dimensions of vehicular and pedestrian entrances, exits, drives, walkways, and lighting. (b) Visibility, in both directions, at exit points. (c) Location, arrangement and screening of off-street parking spaces and waste storage areas. (d) Location, arrangement, size, and adequacy of landscaping provided for screening of parking areas, buildings, utilities, outdoor storage, and buffering. (2) The protection of environmental quality, landscaping of open space and harmony with existing development. The Planning Commission and Township Board of Supervisors shall take into consideration the following features: (a) Arrangement, location, size and architectural features of proposed buildings and structures on the site in relation to development on adjoining properties, open space, topography and existing vegetation. (b) The shielding of light, noise, odors, airborne particles, or other disturbances which could interfere with the use and enjoyment of neighboring properties. (c) The collection and disposal of stormwater runoff from the site. (d) The adequacy of the water supply, fire protection system, and proposed sewage facilities. (e) The adequacy of protection of floodplain and wetland areas. Page 7 of 10

(f) The adequacy of protection against hazards of developing or using land in carbonate geology areas. (g) The adequacy of protection provided for woodlands, steep slopes, rock outcrops, cliffs and quarries. (3) The protection and preservation and reuse of buildings or structures built more than 50 years prior to the date of application. The Planning Commission shall take into consideration the following features: (a) If such buildings and structures are nonconforming as to location, size or use, that such nonconformities are permitted to continue. (b) The adequacy of the proposed protection, renovation, and reuse. Page 8 of 10

CONSENT AGREEMENT I/We the undersigned, having made application to the Planning Commission and Board of Supervisors of Moore Township for approval of a Lot Line Adjustment or Minor Subdivision Plan, do hereby authorize any member of the Board of Supervisors, the Planning Commission, the Township Engineer, and such other persons as may be designated by the aforesaid, to come upon, enter, inspect, and perform such other services and make such other inspections as may be necessary, in the sole discretion of the aforesaid bodies or persons, relative to the said application for Lot Land Adjustment or Subdivision. It is further understood that in consideration for this permission, the proper authorities will process the application of the undersigned for Lot Line Adjustment or Subdivision approval, and the undersigned further agrees to waiver any right to damages or compensation, of any kind, for any actions done pursuant to this authorization. The undersigned understands and agrees that a Plans Review and Inspection escrow account (Escrow Account) must be established and maintained with the Township. The purpose of this Escrow Account is to reimburse the Township for costs associated with professional consulting fees, including, but not limited to, engineer fees and legal fees. The initial amount to establish the Escrow Account is set by annual Resolution. The Escrow Account will have to be replenished from time to time as the Escrow Account is depleted. The undersigned agrees and warrants that it will, upon written notice from the Township, immediately re-establish the Escrow Account to the original sum established by the Township. Further, the undersigned agrees that in the event the Owner/Developer fails to replenish the Escrow Account in accordance with the notice from the Township, then, in that event, reviews and inspections of the Owner/Developer s plans and/or improvements in the field will cease immediately. The undersigned agrees to waive any and all time limits as set forth in the Municipalities Planning Code which obligate the Township to review the Plans or improvement within certain time constraints. Further, the undersigned specifically agrees it will not be entitled to releases, under the terms of the Improvements Agreement and financial security, if the Township Engineer fails to authorize releases, where the undersigned Owner/Developer fails to replenish the Escrow Account. NAME OF LAND DEVELOPMENT (SEAL) (SEAL) DATE Page 9 of 10

APPLICATION SUBMISSION RECEIPT FOR SITE PLAN The Application Submission for Site Plan has been reviewed by and found to have all the required components and has been accepted for submission to the Moore Township Planning Commission for acceptance for a full formal review. This receipt is acknowledgment of such completion by in this day of, 20. Attached is W-9 form to be completed and returned with Application. Page 10 of 10