Form 1 TITLE (Minor Subdivision or Major Subdivision)
Lot Split or
Lot Consolidation or
Lot Consolidation/Lot Split or
Subdivision
Part of original tract
City
County
Date
Form 2A Owner’s Acceptance (Minor Subdivision)
I (we) the undersigned being the owner of the land shown and described hereon, hereby assent to and adopt this Lot Split and/or Lot Consolidation and acknowledge the same was made at our request.
Owner Signature:
Owner Print Name:
Witness Signature:
Witness Print Name:
Form 2B: CERTIFICATE OF OWNERSHIP AND DEDICATION (Major Subdivision)
I (we) the undersigned (name lettered) owner(s) of the property shown and described here on as the subdivision do hereby assent to and adopt this subdivision of the same, and acknowledge that the same was made at our request and do hereby dedicate to public use the streets) (easements) (parks or other public areas) designated in graphic symbols on this plat.
Witness:
Owner Signature:
Owner Print Name:
Owner Signature:
Owner Print Name:
Form 3 ACKNOWLEDGMENT BY INDIVIDUAL (directly below the above certificate) (Minor Subdivision or Major Subdivision)
State of Ohio
County of
Before me, a Notary Public in and for said County and State, personally appeared the above who acknowledged that he (she or they) did sign the foregoing instrument and that the same is his (her or their) free act and deed.
IN WITNESS whereof I have hereunto set my hand and official seal at
,
(City) (State)
This day of ,
(Month) (Year)
Notary Public
My commission expires
Form3A ACKNOWLEDGMENT BY CORPORATION (Minor Subdivision or Major Subdivision)
State of Ohio
County of
Before me, a Notary Public, in and for said County and State, personally appeared , president and , secretary, of , the corporation which executed the foregoing instrument, who acknowledged that they did sign said instrument as such president and secretary in behalf of said corporation and by authority of its board of directors; and that said instrument is their free act and deed individually and as such officers and the free and corporate act and deed of said corporation.
IN WITNESS whereof I have hereunto set my hand and official seal at
,
(City) (State)
This day of ,
(Month) (Year)
Notary Public
My commission expires
Form 4 CERTIFICATE OF SURVEYOR (Minor Subdivision or Major Subdivision)
I hereby certify that I have prepared this survey and plat of subdivision and that the same is correct and accurate.
, 20 .
Registered Surveyor-Ohio Serial No
FORM 5A PLANNING COMMISSION (Minor Subdivision)
This lot split and/or lot consolidation is approved by Planning Commission of the City of Broadview Heights, Ohio adopted this day of , 20 .
Chairperson: Printed Name
Secretary: Printed Name
PLANNING COMMISSION (Major Subdivision)
This plat of subdivision has been approved for record purposes only by the Planning Commission of the City of Broadview Heights this day of , 20 .
Chairperson: Printed Name
Secretary: Printed Name
Form 5B APPROVALS BY COUNCIL (Major Subdivision Only)
This plat of subdivision has been approved by the Council of the City of , Ohio, by Resolution No. , adopted , 20 .
date
President: Printed Name
date
Clerk: Printed Name
Form 6A
(Minor Subdivision)
This lot split and or lot consolidation is accepted and approved by the City Engineer of the City of Broadview Heights, Ohio this day of , 20 .
City Engineer: Printed Name
CERTIFICATE OF THE APPROVAL OF REQUIRED IMPROVEMENTS (Major Subdivision)
I hereby certify that the pavements, utilities and other required improvements for the subdivision herein approved have been designed in accordance with the regulations and standards in effect, that I have estimated the cost of materials and construction, and performance guarantees in the amount of $ have been posted with the to assure completion of all improvements in case of default.
Date
City Engineer
Form 6B CERTIFICATE OF THE APPROVAL OF REQUIRED IMPROVEMENTS (Not included on plat)
I hereby certify that pavements, utilities and other required land improvements for the subdivision approved by the Council on have been designed in accordance with the regulations and standards in effect, that I have inspected the installation of the same and find all improvements have been installed in accordance with the drawing and specifications therefore, and that the utilities and pavements are in good repair.
Date
City Engineer
Form 7 ACCEPTANCES OF PUBLIC LANDS BY COUNCIL (Major Subdivision)
The public streets, park, playground, easements and/or other public areas, as noted hereon in graphic symbols were accepted for dedication by the Council of the City of , Ohio, by Ordinance No. .
Passed , 20 .
date
President
date
Clerk
Form 8 ACCEPTANCES OF STREET AND UTILITIES FOR PUBLIC USE (Major Subdivision)
(Separate ordinance - not included on plat)
The public streets accepted heretofore for dedication and the public utilities have been found to be constructed in accordance with the drawing, specifications and design standards in effect and in good repair and are hereby accepted for public use and maintenance by the Council of the City of , Ohio, by Ordinance No. .
date
President
date
Clerk
Form 9 COUNTY RECORDS (Major Subdivision)
Transferred this day of , 20 .
County Auditor
Recorded in Plat Book , Page No. .
this day of , 20
County Recorder
Form 10
UTILITY EASEMENTS (U.E.L.) (Major Subdivision)
We the undersigned owner of the within platted land, do hereby grant unto the , all Ohio corporations, their successors and assigns (hereinafter referred to as grantees) a permanent right-of-way and easement twelve (12) feet in width under, over and through all lands owned by the grantor shown hereon and parallel with and contiguous to the public thoroughfares, and also upon lands as depicted hereon to construct, place, operate, maintain, repair, reconstruct or relocate such underground electric, gas and communications cables, ducts, conduits, pipes, gas pipe lines, surface or below ground mounted transformers and pedestals, concrete pads and other facilities as are deemed necessary or convenient by the grantees for distributing, transporting and transmitting electricity, gas and communication signals for public and private use at such location as the grantees may determine upon within and across said easement premises. Said easement rights shall include the right, without liability therefore to remove any and all facilities not contemplated in the rights conveyed to the grantees by this easement grant within said easement not limited to irrigation systems, electronic animal fencing, trees and landscaping, including lawns, flowers or shrubbery and landscape lighting within and without said easement premises which may interfere with the installation and maintenance, repair or operation of said electric, gas and communications facilities, the right to install, repair, augment and maintain service cables and pipe lines outside the above described easement premises or the right of access, ingress and egress to and from any of the within described premises for exercising any of the purposes of this right-of-way and easement grant.
(Ord. 03-16, passed 3-7-2016)