§ 7 FORMS FOR PLAT CERTIFICATION

FORM 1: Certificate of Ownership and Dedication (Minor, Preliminary and Final)

I (we) hereby certify that I am (we are) the owner(s) of the property shown and described hereon and that I (we) hereby adopt this plan of subdivision with my (our) free consent, establish the minimum building restriction lines, and dedicate all streets, alleys, walks, parks and other open spaces to public or private use as noted.

_____________________________      _______________

Owner                   Date

_____________________________      _______________

Owner                   Date

FORM 2: Certificate of Accuracy (Minor, Preliminary and Final)

I hereby certify that the survey depicted by this plat was done under my direct supervision by the method of random traverse with side shots. The unadjusted closure ratio was 1:______. The values identified hereon are adjusted values based on a transit rule adjustment. All corner and witness corner locations are monumented with 1/2" conduit in accordance with 201 KAR 18:150, Section 8, with a metallic cap stamped ___________________, except when noted otherwise. I further certify that this plat meets the accuracy standard required by the Lincoln County/Cedar Creek Planning Commission.

_________________________________________         __________________

Registered Licensed Professional Land Surveyor         Date

FORM 3: Certificate of Approval for Recording (Minor and Final)

I hereby certify that the subdivision plat shown hereon has been found to comply with the Subdivision Regulations for Lincoln County, Kentucky, with the exception of such variances, if any, as are noted in the minutes of the Planning Commission and that it has been approved for recording in the office of the County Clerk.

__________________________________      __________________

Chairperson, Planning Commission         Date

FORM 4: Certificate of Availability of Water Supply (Preliminary Plat)

I hereby certify that the ___________ shall supply the ______________Subdivision with services and that the water distribution of said subdivision meets the requirements of this Agency and all other requirements for the proper distribution of water.

____________________________      _______________

Signed                  Date

FORM 5: Certification of the Approval of Streets (Final Plat)

I hereby certify:

(1) that streets have been installed in an acceptable manner and according to county specifications in the subdivision entitled: ______________________ or,

(2) that a security bond has been posted with the Lincoln County Fiscal Court to assure completion of all required improvements in case of default.

______________________________________         ___________________

County Road Engineer                     Date

Form 6: Prohibited Transactions (Preliminary Plat)

This Plat cannot be used for the sale of undeveloped lots, until after a Final Plat has been recorded.

______________________________________         ____________________

Owner                            Date

Form 7: Certificate of Approval of Roadway System (Preliminary Plat)

I hereby certify that the roadway locations and cross-sections proposed to be constructed in the Subdivision shown hereon meet the criteria of the Lincoln County Road Department.

______________________________________         _____________________

County Road Engineer                      Date

Form 8: Subsurface Sewage Disposal Plat Note (Preliminary and Final Plats)

Sewage disposal for this development shall be by a subsurface disposal method approved by the Lincoln County Health Department. Prior to beginning construction on a lot, a person shall obtain a valid subsurface sewage disposal permit issued pursuant to 902 KAR 10:081 and 902 KAR 10:085.