FORM 4. CHECKLIST FOR FILING OF FINAL SUBDIVISION PLAT
Plat Name
Location
Owner
1. Date of Final Approval
Date(s) of Reapproval
2. Bonds or Escrow Deposits:
Public Improvement
Sewer
Other
Other
(Bond Resolution Provided on )
3. Fees: (To Planning Commission)
A. Money in lieu of land
B. Two percent (2%) Inspection Fee or actual cost, whichever is the least.
C. Money in lieu of public improvement
D. Street signs
E. Other
F. Other
4. Map:
Received
Checked:
a. Signature block
b. Owner’s signature
c. Seal(s)
d.
e.
f.
g.
5. Instruments Necessary for Public Improvements (Checked by (City Engineer and City Attorney))
(a) Off-Site (Easements, Servitudes, Arrangements, Deeds)
1.
2.
3.
4.
(b) Streets
1.
2.
3.
4.
5.
FORM 4. CHECKLIST FOR FILING OF FINAL SUBDIVISION PLAT (Cont.)
(c) Road Widening (City, Town, State, Village)
1.
2.
3.
4.
(d) On-Site Drainage (Easements)
1.
2.
3.
(e) Sewer Line (Easements)
1.
2.
(Purpose)
(f) Reserved Lands
1.
2.
(g) Other Right-of-Way
1.
2.
(h) Conformity to Engineering Report
(Instruments checked above to be recorded immediately)
APPROVED FOR FILING:
City Engineer
City Attorney
6. To Planning Commission
1. List of Stockholders
2. Performance Bonds
3. (a) Off-Site Instruments
(b) Title Report*
(c) Releases of Any Existing
Mortgages
4. (a) On-Site Instruments
(b) Agreement of Dedication
(c) Title Report*
(d) Releases of Any Existing
Mortgages
*Can be included in one title report.
5. Water Supply Distribution
Formation (Special District)
6. Sanitary Sewer Formation
(Special District)
Instruments Received
Instrument Approved
Filed
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