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SUBDIVISION APPLICATION City of Horn Lake Planning Department 3101 Goodman Road, W Horn Lake, MS 38637 662-342-3559 Fax: 662-342-3485 Applications due the 1st working day of the month. Submit application fee and plats in accordance with the requirements of the Subdivision Ordinance and this application. Applicants and their engineer/surveyor should be in attendance at the Planning Commission meeting held on the last Monday of each month, the Board of Alderman meeting and at the Technical Review Committee meeting as scheduled. All division of land into two or more lots, tracts, or parcels requires Subdivision approval by the Board of Aldermen. Required plats and fees vary according subdivision classification shown in Section IV: I. SUBDIVISION NAME, LOCATION AND GENERAL DESCRIPTION Proposed Name of Subdivision: Land is located (ft) from the intersection of street and street on the east/west/north/south side of street. Total acres (or sf): Depth: Frontage: Proposed Land Use: Tax Parcel Number: II. ENGINEER OR DESIGNER E-Mail: Fax: III. DEVELOPER OR BUILDER E-Mail: Fax: For Official Use Only: Fees: Receipt No.: Date: Zoning Verified: Sketch: Preliminary Final 1

IV. SUBDIVISION TYPES AND FEES Minor Subdivisions Require Sketch and Final Plat only and are classified as being minor if any one of the following criteria is met: (1) Three or fewer lots, fronting on existing public street, not involving any new public street or road, extension of any municipal facilities or public improvements, and not adversely affection adjoining property;(2).transfer of land between adjacent property owners, not involving creation of any new building sites or lots; (3) Consolidation of lots of record to create a lesser number of parcels that does not involve the creation or extension of any municipal facilities, public improvements and would not adversely affect the rights of the city; or (4) Technical revisions to a record, final plat or any engineering or drafting nature or similar discrepancy and would not affect the rights of the city. Major Subdivisions Require Sketch, Preliminary and Final Plats and includes all not classified as minor above requirements. Minor Subdivisions Sketch Plan: Five (5) copies and application. Final Plat: Three (3) mylars, eleven (11) paper copies of Application and one electronic file of the final Plat plus: Application Fee: $35.00 (payable to City of Horn Lake) Filing Fee: $15.00 plus $2.00 per lot (payable to Desoto County) All other Subdivisions Sketch Plan: Two originals and five (5) copies with application. Preliminary Plat: Two originals and 20 copies of Preliminary Plat; Final Plat: Three (30) 18 x24 Mylars, twenty paper copies and one electronic drawing. (Construction Plans, performance bonds, maintenance bonds and other requirements apply to major subdivisions). Sketch Application Fee: None Preliminary Plat Fee: $200 plus $5.00 per lot (payable to City of Horn Lake) Filing Fee: $15.00 plus $2.00 per lot (payable to Desoto County) Scale of not less than one hundred (100) feet to the inch, with title block and north arrow. See Section VII for Certificates. All specifications for plats may be found in the Horn Lake Subdivision Ordinance. V. PROPERTY OWNER(S) INFORMATION, DECLARATION AND SIGNATURE(S) Email: Email: I (We) as the undersigned owner(s) of the herein described property submit the attached subdivision plat for review by the Planning Commission and approval by the Board of Aldermen. I (we) further verify that information submitted as a part of this application is true and correct to the best of my (our) knowledge and that all material facts relative to this property and the proposed development have been revealed. Signature of Owner Date Signature of Owner Date 2

VI. PLAT and DOCUMENTATION REQUIREMENTS Preliminary Plat Submit plat drawn to a scale of 100 feet to the inch (1 =100 feet) from an accurate survey and on one or more on one or more 18 x 24 sheets. The Preliminary Plat and the accompanying documentation shall show the following: a. Location sketch map showing relationship of site to township, range, section and part of sections. b. North Arrow, graphic scale and date c. Acreage of land to be subdivided d. Contours at vertical intervals of not more than two feet e. Areas subject to periodic inundation (100 year flood elevation) f. Location of existing property lines, streets, buildings, water courses, zoning classifications, and other existing features within the area to be subdivided and similar information regarding existing conditions of adjacent land. g. Location of existing and proposed streets, alleys or access easements, including rights-of-way width, streets names. h. Proposed lot lines, lot numbers and lot layout i. Minimum building set-back lines j. Location of easements, width and purpose k. Proposed use of all land in the subdivision including any reserved areas l. Proposals for sewer and water service shown as a note on plat and any accompanying documentation from appropriate agencies m. Title under which the proposed subdivision is to be recorded, and the name and Mississippi registration number of the engineer, registered land surveyor, planner and subdivider platting n. Subdivider s proposal for construction of improvements. Final Plat Submit plat on drawn to a scale of not more than 100 feet to the inch (1 =100 feet) from an accurate survey and on one or more 18 x 24 sheets. If more than two sheets are required, an index sheet shall be included showing entire subdivision on one sheet and the component areas shown on other sheets. The Final Plat and the accompanying documentation shall show the following: a. Name of subdivision, graphic scale of plat, north arrow oriented toward top of page, date and name of owner or owners of subdivision. b. Location sketch map showing relationship of subdivision site to area including township, range, section and parts of section c. Boundary lines of the area being subdivided with accurate distances and angle d. Lines of all proposed streets, their widths and names. e. Outline of any portions of property intended to be dedicated for public use with statement of dedication thereto. f. Lines of adjoining property, line of adjoining streets and alleys with their widths and names. g. Lot lines with identification of all lots numbered consecutively h. Location of all building lines and easements i. Dimensions, both linear and angular, necessary for locating boundaries of subdivision, lots, streets, alleys, easements, and other areas for public or private use. Linear dimensions to the nearest 1/100ths of a foot. j. Radii, arcs, or chords, points of tangency and central angles for curvilinear street and radii for rounded corners. k. Location of all survey descriptions l. The certificate, Mississippi registration number and legal seal of a registered engineer or land surveyor attending the accuracy of the survey and the correct location of all monuments shown. 3

m. Private restrictions and trusteeships and their periods of existence. If lengthy, make a separate instrument and reference on the plat. n. Acknowledgment of the owner or owners of the plat and restrictions including dedication to public use of all streets, alleys, parks or other open spaces shown thereon and the granting of easements required. o. Restrictive Covenants p. Homeowners or property owners by-laws and Certificate of Incorporation q. If unified development and/or commercial property, evidence of cross access, shared parking agreements and common area maintenance agreements. r. Property certificates for owner, notary public, registered engineer or land surveyor, Planning Commission, Mayor and Chancery Clerk, shown in that order. s. Any other requirements of preliminary approval VII. FINAL PLAT CERTIFICATIONS Owners Certificate: I/We, owner(s) of the property hereon, hereby adopt this as my plan of subdivision and dedicate the right-of-way for the streets and roads as shown on the plat of the subdivision to the public use forever and reserve for the public utilities the utility easements shown on the plat. I/We certify that I/we am/are the owner(s) in fee simple of the property and that no taxes have become due and payable. This the day of -, 20. Owner's Signature Notary s Certificate: State of, County of This day personally appeared before me the undersigned authority in and for said County and State,, who acknowledged that he/they signed and delivered the foregoing subdivision plat for the purpose therein mentioned. Given under my hand and official seal of office this the day of, 20. My Commission Expires: Notary Public 4

Lienholder or Mortgagee's Certificate: I/We, the undersigned mortgagee or lienholder of the property shown hereon, hereby consent and agree to the plat and plan of development as submitted by, owner(s) of the property, Institution Signature Notary s Certificate: State of, County of This day personally appeared before me the undersigned authority in and for said County and State,, who acknowledged that he/they signed and delivered the foregoing subdivision plat for the purpose therein mentioned. Given under my hand and official seal of office this the day of, 20. My Commission Expires: Notary Public Engineer s or Surveyors Certificate: It is hereby certified that this plat is true and correct and was prepared from an actual survey of the property made by me or under my supervision. Engineer or Surveyor Certificate No. SEAL: Date Planning Commission Certificate: Plan of subdivision acted upon and approved by the City of Horn Lake, DeSoto County, Mississippi, Planning Commission on this the day of, 20. Planning Commission Chairperson Attest: Planning Commission Secretary 5

Governing Authority Certificate: I,, do hereby certify that all required improvements have been installed or that a performance surety in sufficient amount to assure completion of all required improvements has been posted and accepted for the subdivision shown on this plat and hereby approved by the City of Horn Lake/ DeSoto County/ Mississippi. Mayor, City of Horn Lake State of Mississippi County of DeSoto I hereby certify that the subdivision plat shown hereon was filed for record in my office at o clock.m., on the day of, 20, and was immediately entered upon the proper indexes and duly recorded in Plat Book, Page Chancery Court Attest: Mayor, City of Horn Lake 6