APPENDIX A: CERTIFICATES AND FORMS
   (A)   A-1 General: All plats must contain all applicable certificates and notations in substantially the same form indicated herein. Deviations in form or wording may be permitted by the Administrator, provided that the certificate or notation fulfills its intended purpose. Additional certificates and/or notations may be required by the official designated to sign the secondary plat where special circumstances warrant such additions.
   (B)   A-2 Surveyor’s Certificate: All plats containing material prepared by a land surveyor shall contain a surveyor’s certificate.
SURVEYOR’S CERTIFICATE
I, (NAME), hereby, certify that I am a professional land surveyor, licensed in compliance with the laws of the State of Indiana; that, to the best of my knowledge, this plat correctly represents a survey completed under my supervision on (DATE); that any changes from the description appearing on the last record of transfer of the land shown on the plat are so indicated; that all monuments shown thereon actually exist or will be installed.
(SEAL)
                                                                                                                                                                              
(Signature)                        (RLS #)                        (Date)
   (C)   A-3 Owner’s Certificate: The basic owner’s certificate required on all plats is as follows:
OWNER’S CERTIFICATE
We, the undersigned, (NAMES), owners of the real estate shown and described herein, do hereby certify that we lay off, plat and subdivide, said real estate in accordance with this plat.
This subdivision shall be known and designated                                                              consisting of                            lots numbered                                .
Clear title to the land contained in this plat is guaranteed. Any encumbrances and special assessments are explained as follows:
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
   (D)   A-4 Additions to Owner’s Certificate: Any of the following paragraphs which are applicable shall be included in the owner’s certificate.
      (1)   All public streets and alleys shown and designated as such and not heretofore dedicated are hereby dedicated to the public. Other public lands shown and not heretofore dedicated are hereby dedicated for the purposes designated hereon.
      (2)   The setback lines shall be determined by the regulations of the governing entity having zoning jurisdiction over the property shown herein.
      (3)   There are strips of ground shown on this plat and marked easement reserved for the use of public utilities and subject to the paramount right of the utility or county to install, repair, maintain, or replace its installation. Drainage use of easements is hereby authorized unless otherwise stated. Those easements noted as surface drainage easements shall not be disturbed in such a manner as to interfere with the flow of stormwater. No plantings, structures, or fill shall be placed in such easements, nor shall they be regraded in such a manner as to impede the flow of stormwater.
      (4)   There are private access easements and/or private streets shown on this plat and marked accordingly. These are intended to be private in perpetuity, and there is no obligation for any government entity to assume any responsibility for these easements and/or streets now or at any future time. The responsibility for maintenance and snow removal on the access easements and/or streets shown on this plat is assumed by the property owners of lots and not by the county.
      (5)   Improvements dedicated to the public by this plat shall not be maintained by the county until the Board of County Commissioners have accepted completed improvements for maintenance. The release by the Board of County Commissioners of a financial guarantee of performance and/or maintenance shall constitute acceptance for maintenance by the county.
      (6)   National flood insurance program certificates.
         a.   Zone A District Certificate:
This subdivision contains property included in the “Zone A District” on the National Flood Insurance Rate/Floodway Map #                                        dated                                . No building may be constructed or substantially improved in the area so designated until a flood elevation has been determined by the Indiana Department of Natural Resources. Any building constructed or substantially improved after the date of this instrument in the “Zone A District” shall be provided with a flood protection grade which is at least two feet above said flood elevation. The flood protection grade is the elevation of the lowest floor of a building or structure. If a basement is included, the basement floor shall be considered to be the lowest floor.
         b.   Floodway Fringe District Certificate:
This subdivision contains property in the “Floodway Fringe District” on the National Flood Insurance Program Flood Insurance Rate/Floodway Map #                                         dated                         . Any building to be constructed shall be provided with a flood protection grade set at or above               feet, M.S.L., which is two (2) feet above the one-hundred (100) year frequency flood. The flood protection grade is the elevation of the lowest floor of a structure. If a basement is included, the basement floor shall be considered to be the lowest floor.
         c.   Floodway District Certificate:
This subdivision contains property included in the “Floodway District” on the National Flood Insurance Program’s Flood Insurance Rate/Floodway Map #                                  dated                      .
NO RESIDENTIAL DEVELOPMENT CAN OCCUR IN THE FLOODWAY DISTRICT. ALL PERMITS TO BE ISSUED FOR LAND LYING IN THE FLOODWAY DISTRICT SHALL BE FORWARDED WITH PERTINENT PLANS AND MATERIALS TO THE INDIANA DEPARTMENT OF NATURAL RESOURCES FOR REVIEW AND COMMENT PRIOR TO ISSUANCE.
      (7)   The farm access easement shown on the plat is to provide access for farm equipment only to the farm land located                                and                                of the property contained in this subdivision.
      (8)   The                                                      maintenance easement shown on the plat is to provide                                        with access to the located or referenced on this plat. The cost of maintenance of the                                               is to be provided by the owners of                       lots.
      (9)   The lots in this subdivision are subject to restrictions and covenants as set forth in Plat Book                       Page                and any amendments thereto.
   (E)   A-5 Notarized Signature Required: The notarized signature of the owner(s) must be included on any plat, in a form similar to the following:
WITNESS OUR HANDS AND SEALS this                      day of                             ,                  .
STATE OF INDIANA      )
                  )   SS:
COUNTY OF CASS      )
BEFORE ME, THE UNDERSIGNED NOTARY PUBLIC, IN AND FOR THE COUNTY AND STATE, PERSONALLY APPEARED                                        WHO ACKNOWLEDGED THE EXECUTION OF THE FOREGOING INSTRUMENT AS HIS/HER VOLUNTARY ACT AND DEED FOR THE PURPOSES THEREIN EXPRESSED.
WITNESS MY HAND AND NOTARIAL SEAL THIS                        DAY OF                          ,                .
                                                               
NOTARY PUBLIC (SEAL)
                                                               
COUNTY OF RESIDENCE
                                                               
MY COMMISSION EXPIRES
   (F)   A-6 Primary Approval Certificate: The following Plan Commission certificate of primary approval for major and minor subdivisions shall appear on all plats of major and minor subdivisions:
PRIMARY APPROVAL
Under authority provided by I.C. 36-7-4-700, Subdivision Control, and any amendments thereto, this plat was given PRIMARY APPROVAL by the County of Cass, Indiana as follows:
Approved by County Plan Commission (or County Plat Committee, if minor subdivision) at a meeting held                                                   . (If a major subdivision, there shall be lines here for the signatures of the Plan Commission President and Secretary and, if a minor subdivision, there shall be adequate lines for all Plat Committee members.)
Void unless secondary approval is received by                                                  .
   (G)   A-7 Secondary Approval Certificate: The following certificate of secondary approval for major and minor subdivisions shall appear on all final plats of major and minor subdivisions:
SECONDARY APPROVAL
All conditions of primary approval have been met and this plat is granted SECONDARY APPROVAL.
Approved by the Administrator                                                                                                    
                                                                                                  
Administrator
Void unless Recorded by                                                               
   (H)   A-8 Construction Plans Certificate: The following certificate shall appear on each sheet of the final construction plans for a major subdivision:
CONSTRUCTION PLANS
This document contains or is a part of the approved construction plans for                                   . The improvements to be installed in this subdivision will not be accepted for maintenance by the County Commissioners unless and until all improvements shown hereon have been installed and are in substantial compliance with these plans.
                                                                 
Administrator
                                                                 
Date
   (I)   A-9 Board of County Commissioners Certificate: The following certificate shall appear on plats containing land and/or improvements to be dedicated to the public.
BOARD OF COUNTY COMMISSIONERS
The dedication(s) shown on this plat is (are) hereby accepted by the Board of County Commissioners of Cass County, Indiana, at a meeting held on the                 day of                   ,                         .
(The following paragraph shall appear on all plats involving improvements for which financial guarantees of performance are posted.)
This acceptance does not constitute acceptance for maintenance by the County. Maintenance by the County shall commence only after the release of the financial guarantee.
BOARD OF COUNTY COMMISSIONERS
                                                              
                                                              
                                                              
                                                              
ATTEST:
                                                              
Cass County Auditor
   (J)   A-10 Subdivisions Containing No Dedications: Subdivisions containing no dedication of land and/or improvements to the public and no vacations of easements or public rights-of-way shall contain the following certificate:
PLANNING DEPARTMENT CERTIFICATION
This subdivision involves no dedication to the public of land or improvements and does not require the signatures of the County Commissioners.
                                                          
Administrator
                                                          
Date
   (K)   A-11 Recording Certificate:
The real property taxes due through the last installment period have been paid and this plat may be recorded. This certificate remains valid through                                                .
                                                            
Treasurer of Cass County
The real property has been duly entered for taxation and transferred on the records of the Auditor of Cass County. This                    day of                       ,                       .
                                                            
Cass County Auditor
Recorded in Plat Book                , page number                         this the                 day of                  ,                   , at o’clock. Instrument Number                                     . Fee paid                                      .
                                                            
Cass County Recorder
   Subdivisions Containing Previously Platted Land: Any plat which contains land in a previously recorded plat shall contain the following certificate:
A notation has been made on the original plat of                                                   Plat Book                     , Page                    .
(Prior Code, Appendix A)