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2. 
3. Kootenai County Surveyor’s Office
   City Subdivision Surveyor Review
4. Phone: 208-446-1570
6. Subdivision Name: (See Plat Naming Policy)
7. See Link Below
   Plat Naming Policy
9. Number of Lots (including open space and utility tracts):
11. Serial #(s):
13. Sec.
14. Twp.
15. Rng.
17. Property Owner:
18. Phone:
19. Email:
21. Address:
22. City:
23. State/Zip:
25. Property Owner:
26. Phone:
27. Email:
29. Address:
30. City:
31. State/Zip:
33. Licensed Surveyor:
34. Phone:
35. Email:
37. Address:
38. City:
39. State/Zip:
41. Required Attachments:
43. Final Plat:
44. Title Report:
45. Surveyor's Checklist:
47. C, P & F's:
48. Closure Reports:
49. Reference Documents:
51. Other: Combine additional docs into single PDF
53. See County Surveyor Web Page for Checklists, Guidelines, Policies and Procedures, and Plat Naming Policy
    Click here for Surveyor Page
55. 
57. Electronic Signature Agreement:*

    1. I Agree
    2. I Do Not Agree

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.
59. Name:*
60. Date:*
    Date:
62. Name:
63. Date:
    Date:
Leave This Blank:


65. 1. Receive an email copy of this form.
66. Email address

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67. Submit

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