INSTRUCTIONS FINAL PLAT APPROVAL APPLICATION

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INSTRUCTIONS FINAL PLAT APPROVAL APPLICATION 1. The applicant/agent shall fill out the attached application. The attached application form must be completely filled in before it can be filed. Portions of the form that are not applicable shall be marked N/A. All applications must be signed by the owner or his duly authorized agent. If the application is signed by an agent, a written authorization from the property owner must be submitted naming the agent and that the owner is aware and approves of the requested platting. 2. The application shall be accompanied by the original tracing of the plat (on Mylar) together with twenty (20) prints of the final plat. 3. The application, original drawing, and copies of the plat shall be filed with the Zoning Administrator at least thirty (30) days prior to a regular Planning Commission meeting at which the final plat is to be considered.

Section No. Township No. Case No. Date Filed Range No. FINAL PLAT APPROVAL APPLICATION Name of Subdivision General Location Name of Property Owner Mailing Address Email Phone Name of Agent Mailing Address Email Phone Name of Surveyor Mailing Address Email Phone

Name of Engineer Mailing Address Email Phone SUBDIVISION INFORMATION: 1. Gross Acreage of Plat 2. Number of Lots a. Residential b. Commercial c. Industrial d. Other Total Number of Lots 3. Minimum Lot Frontage Ft. 4. Minimum Lot Area Acres 5. Existing Zoning 6. Proposed Zoning 7. Public Water Supply (Yes, No) Name 8. Public Sanitary Sewers (Yes, No) Name 9. Health Department Approval (where applicable) (Yes, No)

10. Lineal Feet of New Road(s) a. R/W Ft. b. R/W Ft. c. R/W Ft. d. R/W Ft. e. R/W Ft. TOTAL Ft. 11. Sidewalk adjacent to all streets Yes No 12. Surety Bond submitted with Final Plat ; to be submitted later ; Amount $. 13. All required improvements installed prior to submittal of Final Plat Yes No. The owner herein agrees to comply with the requirements of the Subdivision Regulations for Reno County, as amended, and all other pertinent resolutions and regulations of Reno County, and Statutes of the State of Kansas. It is agreed that all costs of recording the plat and supplemental documents thereto with the Register of Deeds shall be assumed and paid by the owner when billed. The undersigned further states that he is the owner of the property proposed for platting. Owner's Signature Agent (if any) OFFICE USE ONLY: Received by the Zoning Administrator, at (A.M.)(P.M.) on this day of, 20, together with the appropriate fee of $. Name and Title

FINAL PLAT CHECK LIST Name of Subdivision Name of Owner Date Name of Subdivider Name of Person who prepared the Plat Signature of Person who completed this Check-List Instructions: The following check-list is to be completed by the Zoning Administrator, or his designate, and shall accompany the Final Plat when it is submitted to the Planning Commission. If the answer to any of the questions is "No", a written explanation must accompany this check-list. Yes No A. Does the Final Plat show the following information? 1. Name of subdivision 2. Location of section, township, range, county and state, including the descriptive boundaries of the subdivision based on an accurate traverse, giving angular and linear dimensions which must be mathematically correct. The allowable error of closure on any portion of the plat with a perimeter distance of 10,000 feet or more shall be 1 foot in 20,000. The allowable error of closure on any portion of the plat with a perimeter distance of less than 10,000 feet shall be 1 foot in 10,000. 3. Location of monuments or bench marks. Location of such monuments shall be shown in reference to existing official monuments or the nearest established street lines, including the true angles and distances to such reference points or monuments.

Yes No 4. The location of lots, streets, public highways, alleys, parks and other features, with accurate dimensions in feet and decimals of feet with the length of radii on all curves, and other information necessary to reproduce the plat on the ground. Dimensions shall be shown from all curves to lot lines. 5. Lots numbered clearly. Blocks numbered or lettered clearly in the center of the block. 6. Exact locations, widths and names of all streets and alleys to be dedicated. 7. Boundary lines and description of the boundary lines of any area other than streets and alleys, which are to be dedicated or reserved for public use. 8. Building setback lines on the front and side streets with dimensions. 9. Name and address of the developer and licensed surveyor making the plat. 10. Scale of plat, 1" = 100' or larger, date of preparation and north arrow. 11. Statement dedicating all easements. 12. Statement dedicating all streets, alleys, and all other public areas not previously dedicated. B. Were the original (on Mylar, tracing cloth, or similar material) and 20 copies submitted?

Yes No C. Has the developer guaranteed the installation of the following improvements 1. Streets 2. Water 3. Sewers 4. Sidewalks 5. Other improvements as required D. How has installation been guaranteed 1. Actual construction 2. Bond 3. Petition 4. Other E. Signatures 1. Owner or owners and all mortgagors 2. Notarization or notarizations 3. Licensed surveyor that prepared plat 4. Licensed surveyor that reviewed plat F. Title opinion 1. Submitted (Date) 2. Have all owners and mortgagors signed plat G. Has certification been submitted stating that all taxes and special assessments due and payable have been paid H. Deed restrictions 1. Are any deed restrictions planned for subdivision 2. If so, has a copy been submitted

I. Comments:

FINAL PLAT CERTIFICATE AND SIGNATURE BLOCK REQUIREMENTS All final plats submitted for approval must have certain certificates and signature blocks on the face of the final plat. These certifications and signature blocks are required to make the final plat a legal document capable of being recorded with the Register of Deeds. The following are required, where appropriate, on all final plats. 1. A certificate signed and acknowledged by all parties having any record, title, or interest in the land subdivided and consenting to the preparation and recording of the said subdivision map. 2. A certificate signed and acknowledged as above, dedicating all parcels of land shown on the final plat and intended for any public use except those parcels that are intended for the exclusive use of the lot owners of the subdivision, their licensees, visitors, tenants and servants. If the subdivision abuts or is within 100 feet of any FEMA-regulated floodplain or regulatory floodway, the dedicating certificate shall also recite that, "FEMA floodplain and regulatory floodway boundaries are subject to periodic change, and such change may affect the intended land use within the subdivision." 3. A certificate signed by the licensed land surveyor responsible for the survey and final plat. The land surveyor shall not record the plat until all monuments, irons, or benchmarks required by the Subdivision Regulations, have been set. The land surveyor's signature shall be accompanied by the surveyor's seal and shall state the month and year the survey was made in accordance with Reno County Resolution No. 2014-52. 4. The acknowledgment of a notary in one of the following forms: A. For an acknowledgment in an individual capacity: State of Kansas) County of Reno) SS The foregoing instrument was acknowledged before me this xx day of xx, 20 xx, by (names of person(s). (Signature of Notarial Officer) (Seal or Stamp) My commission expires:

B. For an acknowledgment in a representative capacity: State of Kansas) County of Reno) SS The foregoing instrument was acknowledged before me the xx day of x, 20 xx, by name(s) of person(s) as (type of authority, e.g., officer, trustee, president, etc.) of (name of party on behalf of whom instrument was executed) on behalf of (company, partnership, trust, etc.) (Signature of Notarial Officer) (Seal or Stamp) My commission expires: 5. The certification of the Planning Commission in the following form: This plat of has been submitted to and approved by the Reno County Planning Commission, Reno, Kansas. Dated this _xx_ day of, 20 xx. Reno County Planning Commission Chairman Printed Name Secretary Printed Name

6. The plat approval and acceptance of dedications by the Board of County Commissioners, when required, in the following form: This plat approved and all dedications shown hereon, if any, accepted by the Board of County Commissioners of Reno County, Kansas, this _xx_ day of _, 20 xx. Chair Printed Name (SEAL) ATTEST: County Clerk Printed Name 7. A blank space for noting entry on the transfer record in the following form: Entered on transfer record this _xx_ day of, 20 xx. 8. The certificate of the Register of Deeds in the following form: State of Kansas) County of Reno) SS County Clerk Printed Name This is to certify that this instrument was filed for record in the office of the Register of Deeds, this _xx_ day of, 20 xx, at xxxx o clock M; and is duly recorded. Register of Deeds Printed Name Deputy Printed Name

9. The Certificate of the Licensed Surveyor located in Reno County in accordance with Resolution No. 2014-52 in the following form: Reviewed in accordance with K.S.A. 58-2005 on this _xx_ day of, 20 xx. County Surveyor Printed Name Reno County, Kansas 11. Provision for all other certifications, approvals, and acceptances that are now or may hereafter be, required by any statue, ordinance, resolution or regulation. 12. The form of the certification may be modified as necessary with the approval of the legal counsel of Reno County to meet statutory or other requirements.