APPENDIX “C”
“FINAL PLAT APPLICATION “IN ACCORDANCE WITH THE
VILLAGE OF LORDSTOWN SUBDIVISION REGULATIONS
 
A.   NAME OF APPLICANT: _______________________________
   1.   Address: __________________________________________
   2.    __________________________________________________
   3.   Telephone Number:__________________________________
   4.    __________________________________________________
   5.   Fax Number: _______________________________________
   6.    __________________________________________________
 
B.   ENGINEER/SURVEYOR:   _________________________________
   1.   Address:    _______________________________________
   2.   Telephone Number:               Fax Number:                      
   3.    ________________________________________
 
C.   SUBDIVISION NAME   ____________________________________
   1.    Date of Preliminary Plan Approval:    ____________________ 
   2.   Resolution No.    ________________
 
D.      SUBDIVISION LOCATION:
   Street: _________________   Lot/Section No.: ________________
   Location Description:   _______________________________________
   _______________________________________________________________
 
I hereby certify that I have submitted all of the required information for final plat review pursuant to the Village of Lordstown Subdivision Regulations and that all of the information is true and correct to the best of my knowledge.
 
I also hereby acknowledge that I understand I cannot transfer or sell any land by reference to, exhibition of, or by the use of a plat of the subdivision before a plat has been approved and recorded in the manner prescribed in the Village of Lordstown Subdivision Regulations. The description of sublots or parcels by metes and bounds in an instrument of conveyance shall not exempt the transaction from the provisions of these Regulations. I also hereby acknowledge that I understand that if any of the provisions of the Village of Lordstown Subdivision Regulations are willfully violated before a plat of a subdivision is recorded in the office of the County Recorder; or if I dispose of, offer for sale or lease from a time exceeding five (5) years any lot or any part of a lot in a subdivision before the provisions of the Regulations are complied with, I shall be subject to the penalties prescribed in Chapter 711 of the Ohio Revised Code.
 
_______________________________      ____________________
Applicant’s Signature or Authorized Representative   Date
 
Date Received: _________________________________________________
Date of Meeting of Planning Commission: ___________________________
Action Taken by Planning Commission:   __________________________
______________________________________________________________
 
___________________________________      ____________________
Planning Administrator             Date