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Undated Note: This application sholl conform in all respects to Appl ication No. iJleland Subdivision RegulatioMli of the Planning Board of the T ) v'; ,'j !) F VV A P P I r~ G E 11 Feo Received It shallbe submitted in duplicatE~,'N I TH FOUR BLACK AND white prints of the prel iminary IC:lyout of the subdivision. By Dote :>LANNING BOARD Or- TOWN OF WAPP INGER PRELIMINARY LAYOUT APPLICATION FOR SUBDIVISION OF LAND /,- ,,.r.:->- l /f.~ _ 1. Pro p 0 sed Nome of Subdivision 4",- )', -rlj 2 . Locat ion of Property T ax Section Block Lot(s) 3. Name and Address of Record Owner /'1'", ; I ! ~./T If Corporation, give nome c)f aacnt (. ....,' , ;I / /'. / .,' ;. iA.'; 4. A statement of liens, mortgages, or other encumbrances is attached hereto. (If none, so state) 5. A statement of any easements relating to the property is attached hereto. (If none, so state) 6. Deed or deeds recorded in County Clerk's Office: Dote Liber Page 7. I own or have an interest inl abutting property as stated on the attached sheet. (If none, so state) 8. Name, Address, and License Number of i;ngineer or Land Surveyor i /' 9. According to the Dutchess County Soil Survey, the following soi J types are found on this property 10. This propcrty is in the / Zone. 11. Prel iminary layout covelrs Approximate number of Ilots {: I . acres. 12. Does owner propose to submit r=inal Subdivision Plat to cover entire Pre I iminary laYQut I or file same in sections~ ,/ .' If _ ' 13. Does the :'rcl iminary la)'out cover the entire holding of the appl icant" ';. 'f" 14. Does tho al)pl icant propclse to cledica)'o to the publ ic all streets, highways and parks shown on the Preliminary layout',' " (f. 15. Give number of acres which applicanf" propos~s to dedicate '"0 public use for park and/or playground purposes /1 I" /..,t 16. Does owner intend to request any waivers of the requirements of the land Subdivision ;Zegu- lations of this Board upon the submission of the Final Pla;- for approval':~ '" /"--' , If any waivers of requiremcnts arc to be requested, I ist ,-hem and cive reasons why such requiremcnh should be waived. .c , 1 I ,t-,: .1. ,/f"';:;'; ..- '--. /' ( I r /1 / . / 71/ / ./ .".' ./ --. "i: /f-' __ ',.-> l J ,(_f-. ? r /,-( J","'~/ ..., ~ / ./ , / r _, ,'7"" --;.._. /_.,) ;; i~ ,/ .,. ",< I~. I . (Sianed) Owner c; 0atc(; : - 2-