Appendix III

APPLICATION FOR
APPROVAL OF FINAL PLAT
CITY OF NEWARK
LICKING COUNTY, OHIO

Date:                

1.    Name of Applicant                      

   Address                         

   Telephone                         

2.    Name of Surveyor                      

   Address                         

   Telephone                         

3.    Engineer                         

   Address                         

   Telephone                         

4.    Name of Subdivision                      

5.    Date of Preliminary Plat Approval                

6.    Subdivision:                         

      Total Acres                      

      Total Acres in Lots                    

      Total Acres in Roadway                

      Total Acres Other Than Lots or Roadways          

7.    Deed Covenants or
   Restrictions Submitted          Yes        No         

8.    Seven Sets of Drawings (Prints)
   Submitted             Yes        No         

9.    Pilling Fee of $             Paid       Yes        No         

10.    Signage Fee of $    Paid       Yes        No         

11.    Legal Description of Boundary of
   Subdivision Submitted          Yes        No         

                               
Applicant's Signature             Surveyor or Engineer's Signature

Date Received:                         

Date of Planning Committee Meeting When Plat Will be Considered:       

Action by Planning Commission:                   

                               
   Date                   Signature
                  Secretary Planning Commission

(Ord. 93-62. Passed 10-3-94.)