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LAND DIVISION APPLICATION Return or mail to: Saginaw Charter Township Attn: Mr. Steve King 4980 Shattuck Road Saginaw MI 48603 OFFICE FILE NUMBER TAX ROLL # PERMIT FEE: $50.00 CREDIT CARD: CASH: CHECK #: The Land Division provisions of PA 1996, section 109 of the Act, require local approval of division of land before it is sold, when the new parcel is less than 40 acres and not just a property line adjustment. A municipality shall approve a proposed division within forty-five (45) days after the filing of the proposed division application. 1. PROPERTY OWNER INFORMATION: Name: _ Telephone: ( ) _ Mailing Address: City: State: Zip: 2. APPLICANT INFORMATION (If Not The Property Owner): Contact Person s Name: Telephone: ( ) _ Business Name: Address: City: State: Zip: 3. PARENT PARCEL INFORMATION: Property Address Parent Parcel Tax ID Number: a) Attach a copy of the Legal Description of the Parent Parcel before the division. b) Are there any unpaid property taxes for the Parent Parcel? _ c) Deferred or Special Assessments: _ d) Current zoning of Parent Parcel: 1

4. PREVIOUS DIVISIONS Attach copies of all previous divisions of the parent parcel after March 31, 1997: _ 5. PROPOSED DIVISION Describe the division(s) being proposed: a) Number of new parcels: b) Intended use (residential, commercial, etc.) c) The division of the parcel provides access to an existing public road by (check one): Each new division has frontage on an existing public road. A new public road, proposed road name: A new private road, proposed road name: _ A recorded easement (driveway). 6 a. Attach a legal description of the proposed new road, easement or shared driveway. 6 b. Attach a legal description for each proposed new parcel. 6 c. A description of any division rights transferred from the parent parcel to another parcel? Identify the other parcel: (See Section 109(2) of the Land Division Act. Make sure your deed includes both statements as required in Section 109(3) and 109(4) of the Act.) 7. DEVELOPMENT SITE LIMITS (Check each that represents a condition which exists on the parent parcel.) Any part of the parcel: includes a wetland. is within a floodplain. is known or suspected to have an abandoned well, underground storage tank or contaminated soils. other known site limits. 2

8. ATTACHMENTS (All attachments must be included.) Letter each attached as shown here. A. A survey, sealed by a professional surveyor of proposed division(s) of parent parcel, or a map, drawn to scale, of the proposed division(s) of the parent parcel showing: 1) boundaries as of March 31, 1997, and 2) all previous divisions made after March 31, 1997 (indicate when made or none,), and 3) the proposed division(s), and 4) dimensions of the proposed divisions, and 5) existing and proposed road/easement right-of-way(s), and 6) easements for public utilities from each parcel to existing public utility facilitates, and 7) any existing improvements (buildings, wells, septic system, driveways, etc.) 8) any of the features checked in question number 6. B. Indication of approval, or permit from County Road Commission or MDOT for each proposed new road, easement or shared driveway. C. A copy of any transferred division rights (Section 109(4) of the Act) in the parent parcel. D. A fee of $50.00. E. Other (please list) 9. IMPROVEMENTS Describe any existing improvements (attach extra sheets if needed) which are on the parent parcel, or indicate none (attached extra sheets if needed): 10. AFFIDAVIT I agree the statements made above are true, and if found not to be true this application and any approval will be void. Further, I agree to comply with conditions and regulations provided with this parent parcel division. Further, I understand this is only a parcel division which conveys only certain rights under the applicable local land division ordinance, the local zoning ordinance, and the State Land Division Act (formerly the Subdivision Control Act, P.A. 288 of 1967, as amended and does not include any representation or conveyance of rights in any other statute, building code, zoning ordinance, deed restriction or other property rights. Finally even if this division is approved, I understand zoning, local ordinances and State Acts change from time to time, and if changed the divisions made here must comply with the new requirements (apply for division approval again) unless deeds, land contracts, leases or surveys representing the approved divisions are recorded with the Register of Deeds or the division is built upon before the changes to laws are made. Property Owner s Signature Date 3

11. LAND DIVISION APPLICATION CHECKLIST YES NO N/A APPLICATION COMPLETE A. All questions are answered. B. Property owner, agent information provided. C. Proof that all due and payable taxes and special assessments have been paid. D. Map, survey of the parent parcel and proposed division showing: 1) current boundaries (as of March 31, 1997), and 2) all previous divisions made after March 31, 1997 (indicate when or none), and the proposed division(s), and 3) the proposed division(s), and 4) dimensions of the proposed divisions, and 5) existing and proposed public or private road/easement right-ofways, and 6) any existing improvements (buildings, wells, septic system, driveways, etc.), and 7) any of the features checked in question 6, and 8) for development sites, easements for public utilities from each parcel to existing public utility facilitates. E. Proposed legal description for a new road(s) or easement(s) F. Review materials from the Saginaw County Road Commission, MDOT, or Saginaw Charter Township Community Development Department for each proposed new road, public or private easement or shared driveway. G. Proposed legal descriptions for each new division H. A copy of any transferred division rights in the parent parcel I. Municipal/Zoning and Ordinance - Approved by Community Development Department J. Affidavit/application is signed by property owner and applicant (If any of the above is checked NO, return incomplete application for missing material 12. MUNICIPAL ZONING AND ORDINANCE (For Use By Community Development Department) a) Zoning district for proposed divisions: Zoning Ordinance (municipality) and effective date: b) Complies with minimum square foot size of: c) Complies with minimum lot/frontage/width: d) Complies with minimum public road frontage: _ e) Complies with lot coverage: f) Complies with setbacks: g) Complies with width to depth ratio of: 4:1 N/A h) Complies with private road requirements of the Saginaw Charter Township Land Development Code i) Complies with other applicable provisions of the Saginaw Charter Township Land Development Code j) Has obtained a variance from the above requirements from the Saginaw Charter Township Zoning Board of Appeals k) County Road Commission or MDOT has approved each proposed new road, easement or shared driveway: l) Future division rights have been transferred to: m) Unbuildable lots Reviewed By: Date: Approved Denied 4

YES NO N/A Assessing Office Review: B. Proposed division(s) complies with Section 108 of the statute C. Legal description is adequate for each proposed parcel D. For development sites, easements are adequate for public utilities from each new division to existing public utility facilities Reviewed By: Date: Approved Denied YES NO N/A Administrators Review: A. Proposed division(s) have approval from Assessor s Office B. Proposed division(s) have approval from the Community Development Department for access to a public road from a new road or easement C. Adequate easements for electricity, phone, gas, water, sewer, CATV, drainage, other YES NO N/A Conclusion: A. Are there any of the above marked NO? (Letter of denial giving reason sent) B. Approved Conditions: C. Approved on a preliminary basis. Conditions: Approved or Denied by the Zoning Administrator: Initials: Date: Comments: Approval of a division is not a determination that the resulting parcels comply with other ordinances or regulations. REVISED 01/18 5