Town of Berne
PLANNING BOARD –SUBDIVISION FEE CALCULATION SHEET

SUBDIVISION#___________________ SBL#:_______________

APPLICANT’S NAME___________________________

OWNER OF RECORD___________________________

ADDRESS:_____________________________________

CLASSIFICATION MAJOR/MINOR (Circle One)

NUMBER OF LOTS CREATED:

MINOR SUBDIVISION MAJOR SUBDIVISION DATE PAID

1. Application $100.00 $500.00 ____/____/____

(additional $100 per lot over 5)

2. Preliminary Submission N/A $200.00 + ($50.00 x ( ) Lots) ___/____/_____

(Preliminary Plat)

3. Final Approval 50.00 +(50.00 x ( ) Lots) $200.00 +( $50.00 x ( ) Lots) ____/____/____

=$ =$

________________________________________________

4. Recreation $50.00 x ( ) Lots $300.00 x ( ) Lots ____/____/____

=$____________ =$_____________

Total $__________ Total $__________

ADDITIONAL FEES – See Planning Board Chairperson for Applicability

6. Town Engineer Review $_________________ $_________________ ____/____/____

7. Town Engineer Inspection $_________________ $_________________ ____/____/____

Notes: 1. Planning Board Secretary is to attach this form to the application when it is received. A copy will be furnished to the applicant as a disclosure of fees due based on application contents.

2. Planning Board Secretary will give Zoning and Building Administrator a copy of the final form at the

time of Subdivision Approval. The Zoning Administrator will record payment receipt and furnish a copy of the completed form to the Planning Board Secretary and the applicant.

Revised 9/07