APPENDIX A
SUBDIVISION FORMS
   Form No.    901    Preliminary Plat Checklist
         902    Final Plat Checklist
         903    Technical Design and Improvement Checklist
         904    Application for Tentative Approval of Preliminary Plat
905    Application for Final Plat Approval
         906    Application for Subdivision Variance
Form 901
 
PRELIMINARY PLAT CHECKLIST
Date                                               Application Number                               
Subdivision                                                                                          
The following item(s) (does, does not) conform with the requirements of the North Kingsville Subdivision Regulations. Those items not conforming are explained on the final page:
    Does    Does not    Item
1.                                             Name of Subdivision (no duplication permitted)
2.                                            Location description
3.                                            Name and address of owner, subdivider, surveyor and engineer
4.                                            Sheet size not larger than 24" x 36" (index sheet, if more than 1 sheet)
5.                                            Scale
6.                                            Date and north point
7.                                            Vicinity map
8.                                            Names of adjacent subdivisions and owners
9.                                             Zoning classification of all parcels and proposed changes
10.                                         Contours at 2' intervals
11.                                         Location, width and names of existing streets,
               right of ways, easements
12.                                         Location and dimensions of existing buildings and parks
13.                                          Corporation, ownership, range, section lines
14.                                         Location and/or plan of existing and proposed utilities
15.                                         Layout, names and widths of proposed streets or easements and proper dedications
16.                                         Layout and approximate dimensions of all lots
17.                                         Building set-back lines
18.                                         Parks and open spaces and proper dedications
19.                                         Copy of proposed deed restrictions, if any
20.                                         Required certifications
Date                                                         Title of Position
                                                          Signature
Form 902
 
FINAL PLAT CHECKLIST
Date                                  Application No.                       
Subdivision                                                                            
The following item(s) (does, does not) conform with the requirements of the North Kingsville Subdivision Regulations. Those items not conforming are explained on the final page.
   Does    Does not    Item
1.                                 Submitted within 12 months of preliminary approval
2.                                  Conforms to preliminary plat and incorporates suggested changes
3.                                  Name of subdivision
4.                                  Bar scale
5.                                  Date and north point
6.                                  Locational map
7.                                  Sheet else not larger than 24" x 36" (index sheet if more than 1 sheet (21" x 26" for recording)
8.                                  Name and address of owner, surveyor and engineer
9.                                  Accurate survey data-seconds; linear dimensions to hundredths of feet; radii; internal angles; points of curvature; tangent bearing; lengths of arcs; lengths of cords
10.                                  Gross acreage, lot acreage, road acreage and road mileage
11.                                  Bearings and distances to permanent monuments
12.                                  Name, location, width and centerline of streets within and adjoining this plat, plus mileage of streets within the plat
13.                                  Lot numbers and dimensions and acreage
14.                                  Location and description of monuments
15.                                  Building set-back lines
16.                                  Parks and open spaces and proper dedications
17.                                  Copy of deed restrictions
18.                                  Final improvements plans
19.                                  Installation or guarantee of installation of improvements
20.                                  Required final certificates (See Appendix B)
21.                                  Easements and right of way
Date                                                                   Title or Position
                                               Signature
Form 903
 
TECHNICAL DESIGN AND IMPROVEMENT CHECKLIST
   The following item(s) (does, does not) conform with the requirements of Chapters 1117 and 1119 of the North Kingsville Subdivision Regulations. Those items not conforming are explained on the final page.
   Does    Does not    Item
               General
1.                                 Conformity with major street plan
2.                                  Conformity with zoning regulations, or if no zoning see Section 1117.10
3.                                  No flood hazards
4.                                  Acceptable natural drainage and erosion control
5.                                  Steep slopes not limiting factor
6.                                  Large trees and other significant natural features
7.                                  Areas of historical or cultural significance
               Streets
8.                                  Right-of-way widths
9.                                  Pavement widths
10.                                  Radius of curvature
11.                                  Horizontal visibility
12.                                  Vertical alignment and visibility
13.                                  Grades
14.                                  Cul-de-sacs
15.                                  Turnaround radius-R/W and pavement
16.                                  Dead-end streets
17.                                  Dedication and addition of half streets
18.                                  Marginal access streets, points of access and planting strips
19.                                  Alleys
20.                                  Alignment of intersections
   Does    Does not   NA    Item
21.                                         Spacing of intersection relative to different road classifications
22.                                         Avoidance of multiple intersections
23.                                        Avoidance of 4-way intersections
24.                                         Pavement and right of way intersections
25.                                         Streets for commercial subdivisions (Section 1117.04(f))
26.                                         Repair of pavement
27.                                         Streets for industrial subdivisions (Section 1117.04(g))
28.                                         Length of blocks
29.                                         Crosswalks
30.                                         Street monuments
31.                                         Subgrade
32.                                         Base course
33.                                         Surface course
34.                                         Curbs and gutters
35.                                         Bridges
36.                                         Sidewalks
37.                                         Street names and numbers, signs
               Lots
38.                                         Size
39.                                         Set-back lines
40.                                         Corner lot size
41.                                         Avoidance of double frontage lots
42.                                         Driveway culverts and grade
43.                                         Monuments
44.                                         Grading plan
   Does    Does Not    NA    Item
               Others
45.                                         Parks and open spaces
46.                                         Type of water supply
47.                                         Test wells
48.                                         Type of sewage treatment
49.                                         Percolation test results
50.                                         Storm drainage system type
51.                                         Manholes
52.                                         Catch basins
53.                                         Headwalls
54.                                         Sufficient easements for utilities or open drainage
55.                                         Other utilities
56.                                         Underground utilities
Date                                                               Title
                                         Signature
Form 904
 
APPLICATION FOR TENTATIVE APPROVAL OF PRELIMINARY PLAT
North Kingsville, Ohio
Date                                       
1.    Name of Applicant                                                                       
   Address                                                                                     
   Phone                                                                                        
2.    Name of Surveyor or Engineer                                                        
   Address                                                                                      
   Phone                                                                                        
3.    Name of Subdivision:                                                                    
4.    Location Description:    Section                 Range                     
            Other                                                
(In addition, please attach copy of legal description)
5.    Proposed Use                                                                               
6.    Present Zoning District                                                                  
7.    Proposed Zoning Changes                                                               
8.    Number of Lots                                     Area of Parcel                     
9.    Do you propose deed restrictions? Yes                  No                         
   (If yes, please attach a copy)
10.    What type of sewage disposal do you propose?                                    
If an "on lot" type of sewage disposal is proposed include a letter from the County Board of Health approving a specific type of sewage disposal.
11.    List all proposed improvements and utilities and state your intention to install or post a guarantee prior to actual installation.
   Improvement   Installation       Guarantee
a.                                                                               
b.                                                                               
c.                                                                               
d.                                                                               
e.                                                                               
f.                                                                               
 
12.    List other materials submitted with this application.
         Item             No.
a.                                                                                        
b.                                                                                        
c.                                                                                        
d.                                                                                        
e.                                                                                        
f.                                                                                        
                                                                                    
Applicant          Surveyor or Engineer
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
   For Official Use
Date Received                                                                             
Date of Meeting of Planning Commission                                          
Action by Planning Commission                                                      
If plat rejected, reason(s) for rejection                                               
                                                                                                
                                                                                                
                                                                                                
                                                                                                
Date                                  Chairman                                                
Form 905
 
APPLICATION FOR FINAL PLAT APPROVAL
North Kingsville Village
Date                                         Application No.                              
1.    Name of Applicant                                                                 
   Address                                                                                
   Phone                                                                                   
2.    Name of Surveyor or Engineer                                                   
   Address                                                                                
Phone                                                                                    
3.    Name of Subdivision                                                               
4.    Date Preliminary Plat Approved                                                
5.    Was a zoning change requested?                    Yes                  No
If yes, the plat may not be approved until it conforms with the local zoning. Include a certification of zoning compliance if a change was requested.
6.    Have all required improvements been installed?                Yes                No If no, include detailed estimates of cost and a statement relative to the method of improvement guarantee. All estimates must be approved by the responsible (municipal, county) official.
7.    Do you propose deed restrictions?                  Yes                     No
(If yes, please attach a final copy )
8.    List other materials submitted with this application.
       Item          No.
a.                                                                                              
b.                                                                                              
c.                                                                                              
d.                                                                                              
e.                                                                                              
f.                                                                                              
g.                                                                                              
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For Official Use
Date Received                                                                                 
Date of Meeting of Planning Commission                                              
Plat Fee $                               Inspection Fee $                                    
Action by Planning Commission                                                           
If plat rejected, reason(s) for rejection                                                    
                                                                                                     
                                                                                                     
                                                                                                     
                                                                                                     
Date                            Chairman                                                    
Form 906
 
APPLICATION FOR SUBDIVISION VARIANCE
                                                                Planning Commission
                                     Ohio
Date                                      Application No.                              
Name                                                                                          
Phone                                                                                           
1.    Location Description:                                                               
                                                                                               
                                                                                               
                                                                                               
2.    Nature of Variance Requested: Describe generally the nature of the variance
                                                                                                
                                                                                                
                                                                                                
3.    Justification of Variance: On a separate sheet, please attach a statement relative to why the variance from requirements of the Subdivision Regulations is requested. Include such items as:
   a.    exceptional topographical or other conditions peculiar to this particular parcel of land;
   b.    why a literal interpretation of the regulations would deprive the applicant of rights enjoyed by other property owners;
   c.    that the peculiar conditions do not result from previous actions of the applicant;
   d.    that the requested variance is the minimum variance that will allow a reasonable division of the land;
   e.    a sketch of the area showing the location and characteristics of the requested variance.
I certify that all information contained in this application and its supplements is true and correct.
                                                                   
               Signature
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For Official Use Only
Date Filed                                                                                         
Action                                                                                              
                                                                       
                                                                                                        
                                                                                                         
                                                                  
         Chairman