APPENDIX A: CERTIFICATES AND NOTATIONS
 
   1.   Surveyor Certificate. The following certificate shall appear on all plats:
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 by me, or under my direct supervision, on (date) ; that any changes from the description appearing on the last record transfer of the land contained in the final plat are so indicated; that all monuments shown thereon actually exist or will be installed (before the release of the financial guarantees) and their position is correctly shown, and, that all dimensional and geodetic data are correct.
                                                      
      (Signature)            (Date)
   2.   Owner Certificate. The applicable portions of this certificate shall appear on all plats.
We, the undersigned (names) , owners of the real estate shown and described herein, do hereby certify that we plat and subdivide said real estate in accordance with this plat.
The subdivision shall be known as designated as                                consisting of            lots and               blocks and containing                acres.
All rights-of-way and public lands shown and not heretofore dedicated or deeded to the public are hereby reserved for public use.
Clear title to the land contained in this plat is guaranteed. Any encumbrances and special assessments are explained as follows:
The setback lines shall be determined by the regulations of the Seymour, Indiana Zoning Ordinance of current adoption.
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 city to install, repair, maintain or replace its installation.
All drainage easements identified on the plat are specifically authorized to be used for drainage purposes. All grades shall be maintained as constructed. Additional cut and fill work within drainage easement areas is prohibited unless authorized by the Seymour Plan Commission.
WITNESS OUR HANDS AND SEALS this       day of               , 20    .
Before me, the undersigned Notary Public, in and for the County and State, personally appeared                             and each separately and severally acknowledged the execution of the foregoing instrument as his or her voluntary act and deed, for the purposes therein expressed.
Witness my hand and Notarial Seal this       day of                            , 20    .
                                               
      Notary Public      (Seal)
   3.   Primary Approval Certificate. Plan Commission Primary Approval Certificate (for all plats which are approved by the full Plan Commission).
   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 Seymour, Indiana as follows:
   Approved by the City Plan Commission at a meeting held                                , 20     .
                                               
      President
                                               
      Secretary
Void unless Secondary Approval is received by                                     , 20     .
   4.   Secondary Approval Certificate.
   SECONDARY APPROVAL
All conditions of Primary Approval have been met and this plat is granted SECONDARY APPROVAL.
      Approved by the Building Commissioner                                       , 20     .
                                              
      Building Commissioner
      Void unless recorded by                                 , 20     .
   5.   Plat Committee Minor Plat Approval.
   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 Seymour, Indiana, as follows:
Approved by the Plat Committee at a meeting held                                                              .
                                        
      Chairman
                                        
      Secretary
Void unless Secondary Approval is received by                                 ,         .
   6.   Improvement Plans Certificate.
   IMPROVEMENT PLANS
This document contains or is a part of the approved improvement plans for the following subdivision:                               . The improvements to be installed in this subdivision will not be accepted for maintenance by the Board of Public Works and Safety unless and until all improvements shown hereon have been installed and are in substantial compliance with these plans.
                                        
      City Engineer
                                              
      Date
   7.   Dedication Certificate.
   BOARD OF PUBLIC WORKS AND SAFETY DEDICATION ACCEPTANCE
Be it resolved by the Board of Public Works and Safety, City of Seymour, Indiana, that the dedications shown on this plat are hereby approved and accepted this     day of                 .
                                              
      Chairman
                                              
      Attest:
   8.   Tax Certificate. The following certificate shall appear on all plats:
   TAX CERTIFICATE
The real property has been duly entered for taxation and transferred on the records of the Auditor of Jackson County.
      This         day of                         ,        .
                                              
      Jackson County Auditor
   9.   Flood Hazard Notation. All plats located within or partially within the flood hazard area shall add the following notation to the owner’s certificate:
Minimum flood protection. The minimum flood protection grade in                      is set at or above          feet, M.S.L., which is two (2) feet above the 100-year frequency flood.
The above certificate is not required for administrative and agricultural plats in Zone A (elevation undetermined); however, the extent of the floodplain as shown on the FIRM or FBFM must still be shown on the plat.
   10.   Private Access Easement or Street Notation. Those plats containing private access easements or private streets shall add the following notation to the owner’s certificate:
This plat contains property shown as private [access easements] [streets]. The responsibility for maintenance and snow removal shall be assumed by the property owners and not by the City.
   11.   Recording Notations.
      (a)   Recording is hereby authorized by the owners:                                            .
      (b)   Entered for taxation this         day of                                 ,         .
      (c)   Recorded in Plat Book      , page number      , this the       day of             ,         , at        o’clock. Instrument No.                Fee Paid.
                                                     , Recorder, Jackson County.
      (d)   Copy of plat received by                                                  , Auditor.
   12.   Replat Notation. Replats and plat amendments shall contain the following as part of the recording notation:
Notation made on the original plat of                                 , Plat Book         , Page         .
   13.   Sewage System Covenant. As required in Article III, Section B.13.e of the Subdivision Control Ordinance if Seymour, Indiana, the covenants applying to any major subdivision utilizing an alternative sewage disposal system shall include the following:
The (Name of Subdivision) Lot Owners Association shall be responsible for the repair, maintenance, improvement, and replacement of the sewage disposal system installed within (Name of Subdivision) pursuant to the provisions of Article III, Section B.13 of the Subdivision Control Ordinance of Seymour, Indiana.