Appendix B. CERTIFICATES AND STATEMENTS FOR PRELIMINARY PLATS

1.

Certificate of Ownership & Dedication

On the face of the Final Plat, there shall appear a certificate of ownership and dedication acknowledged before an officer authorized to take acknowledgements and executed by the person making the acknowledgement. The certificate shall include a statement of ownership of the property shown on the plat, of its location within the County's subdivision jurisdiction, and of the free consent with which this Ordinance's requirements are met as to setbacks and dedications. If sanitary sewers, storm sewers, and water lines are to be included in the subdivision, the certificate shall also include a statement of their dedication to the County or a public utility designated by the County. The certificate shall state:

I hereby certify that I am the owner of the property shown and described hereon, which is located in the subdivision jurisdiction of the County of Iredell and that I hereby adopt this plan of subdivision with my free consent, establish minimum building setback lines, and dedicate all roads, alleys, walks, parks, and other sites and easements to public or private use as noted.

Furthermore, I hereby (certify that no sanitary sewers, storm sewers, or water lines are to be included in the subdivision)(dedicate all sanitary sewer to ________________, all storm sewer system to _________________ and all water lines to ____________).

I further certify that:

a.

there are no deed restrictions which will be violated by the requested subdivision; and

b.

there are no governmental regulations of any kind, other than those for which a variance has been applied for under the Iredell County Subdivision Ordinance regulations, which will be violated by the requested subdivision; and

c.

I understand that enforcement of deed restrictions and any other contractual agreements is not the responsibility of Iredell County, will not be undertaken by Iredell County, and is the sole responsibility of the parties affected by violations of such deed restrictions and contractual agreements.

      __________________________

      Owner     

North Carolina

_________ County

I, a Notary Public for said County and State, do hereby certify that _______________, owner(s) personally appeared before me this day, and acknowledged the execution of the foregoing instrument. Witness my hand and official seal, this _____ day of ___________, 20___.

      ________________________

      Notary Public   

My Commission Expires: _______________________"

2.

Certificate of Survey and Accuracy

In Accordance With North Carolina General Statutes Chapter 40, Section 30, as amended and With the Standards of Practice for Land Surveying in North Carolina:

There shall appear on each plat a certificate by the person under whose supervision the survey or plat was made, stating the origin of the information shown on the plat, including recorded deed and plat references shown thereon. The ratio of precision before any adjustments must be shown. Any lines on the plat that were not actually surveyed must be clearly indicated and a statement included revealing the source of information. Where a plat consists of more than one sheet, only one sheet must contain the certification and all other sheets must be signed and sealed.

The certificate required above shall include the source of information for the survey and data indicating the ratio of precision of the survey before adjustments and shall be in substantially the following form:

I, ______________________, certify that this plat was drawn under my supervision from an actual survey made under my supervision (deed description recorded in Book ____, page ____, etc.) (other); that the boundaries not surveyed are clearly indicated as drawn from information found in Book ____, page ____; that the ratio of precision as calculated is 1:________; that this plat was prepared in accordance with G.S. 47-30 as amended. Witness my original signature, registration number and seal this ______day of _______, A.D.,20___.

Seal or Stamp

      ___________________________

      Surveyor    

      __________________________

      Registration Number  

3.

Water Supply Watershed Certificate

All subdivisions of land shall have a statement signed by the Subdivision Administrator indicating whether or not a subdivision lies within a designated Water Supply Watershed. Said statement shall take one of the following forms, as appropriate:

(a)

The (name of subdivision) Subdivision, to the best of my knowledge, does not lie within a Water Supply Watershed designated by the Environmental Management Commission as appears on the Watershed Protection Map of Iredell County.

___________________       _______________________________

         Date       Subdivision Administrator   

(b)

Lots (fill in appropriate lot numbers) of the (name of subdivision) Subdivision, to the best of my knowledge, lie within the (classification of watershed) of the (name of body of water) , as designated by the Environmental Management Commission as appears on the Watershed Protection Map of Iredell County. Lots (fill in appropriate lot numbers) of the (name of subdivision) do not lie within a water supply watershed.

_____________________       ________________________________

         Date       Subdivision Administrator   

(c)

All lots within the (name of subdivision) , to the best of my knowledge, lie within the (classification of watershed) of the (name of body of water) , as designated by the Environmental Management Commission and as appears on the Watershed Protection Map of Iredell County.

______________________       ________________________________

         Date       Subdivision Administrator   

4.

Certificate of Approval for Preliminary Plat

If the Subdivision Administrator approves the Preliminary Plat or if the plat is approved on appeal to the Planning Board or to the Board of Commissioners, such approval shall be shown on each copy of the plat by the following signed certificate:

I hereby certify that the preliminary subdivision plat shown hereon has been found to comply with the Subdivision Regulations of the County of Iredell, North Carolina and that this plat has been approved by the Subdivision Administrator.

______________________       ________________________________

        Date       Subdivision Administrator   

5.

Private Water/Sewer Statement

As of the date of this recording, the lots represented on this plat have not been inspected or approved by the Iredell County Health Department. Until inspected, there is no assurance that a building permit will be issued.