Appendix I. OFFICIAL FORMS OF THE ATMORE PLANNING COMMISSION

ATMORE PLANNING COMMISSION APPLICATION FOR PRELIMINARY SUBDIVISION PLAT APPROVAL

Date _____

Name of Subdivision (PUD) _____

Name of Applicant/Owner _____

Address _____
    (Street or P. O. Box)      (City)      (State)      (Zip)

Name of Local Agent/Engineer, if other than Applicant

_____________________________________________ Phone _____

Address _____
    (Street or P. O. Box)      (City)      (State)      (Zip)

Subdivision (PUD) Location: (Use back of page if more space is required.)

 

Total Acreage ________________________________ Zone _____

Number of Lots (Units) ________________________________ Average Lot Size _____

Water Source _________________________________________________ (Name if Public)

Sewer Source _________________________________________________ (Name if Public)

Owners of Land 100 feet Adjacent or Opposite:

	Name	Address
1.	_____________________	_____________________
2.	_____________________	_____________________
3.	_____________________	_____________________
4.	_____________________	_____________________
5.	_____________________	_____________________

 

Attached is a check payable to the City of Atmore in the amount of $25.00 for a filing fee and $5.00 per lot or unit in the development. For a PUD, an additional fee of $2.00 per 1,000 square feet of non-residential land area is attached. TOTAL $ _______________.

	(Name of Applicant       or Agent)

ATMORE PLANNING COMMISSION PRELIMINARY PLAT CHECKLIST

Subdivision Name ______________________________________ Date _____

1. ___ Application forms completed.

2. ___ Filing fees paid.

3. ___ Eight (8) copies of plat submitted 15 days prior to meeting.

4. ___ Public hearing notices sent.

5. ___ Preliminary Plat requirements met.

a. ___ Name of owners of record.

b. ___ Name of subdivision, date, north point, scale, and location.

c. ___ Name and seal of registered land surveyor and civil engineer.

d. ___ Vicinity Map.

e. ___ Exact boundaries shown with bearings and distances and signature of registered land surveyor.

f. ___ Names and address of land owners adjoining the tract of land to be subdivided.

g. ___ Wooded areas, marshes and other conditions affecting site.

h. ___ Location of existing streets, buildings, water courses, railroads, transmission lines, sewers, water mains, drainage structures, public utilities, jurisdiction lines, and public utility easements on and adjacent to tract being subdivided.

i. ___ Proposed rights-of-way or easements including location, widths, purposes and street names.

j. ___ Proposed lot lines with bearings and distances and lot and block numbers.

k. ___ Proposed minimum building setback lines.

l. ___ Proposed parks, school sites, or other public open spaces.

m. ___ Site data including total acreage, smallest lot size, total number of lots and linear feet of streets.

n. ___ Flood hazard areas.

o. ___ Existing zoning classification.

p. ___ Inscription stating "NOT FOR FINAL RECORDING".

6. ___ Construction plans submitted.

a. ___ Street plan.

b. ___ Storm drainage plan.

c. ___ Sanitary sewer plan.

d. ___ Water distribution plan.

e. ___ Gas distribution plan.

f. ___ Construction Cost Estimate.

ATMORE PLANNING COMMISSION APPLICATION FOR
FINAL SUBDIVISION PLAT APPROVAL

Date _____

Name of Subdivision (PUD) _____

Name of Applicant/Owner _____

Address _____
    (Street or P. O. Box)      (City)      (State)      (Zip)

Name of Local Agent/Engineer, if other than Applicant

__________________________________________ Phone ;lf_;

Address _____
    (Street or P. O. Box)      (City)      (State)      (Zip)

Subdivision (PUD) Location: (Use back of page if more space is required.)

 

Total Acreage ___________________________ Zone _____

Number of Lots (Units) ___________________ Average Lot Size _____

Water Source _________________________________________________ (Name if Public)

Sewer Source _________________________________________________ (Name if Public)

Date of Approval of Preliminary Plat _____

Conditions, Restrictions or Other Requirements Placed on Preliminary Plat (Use back of page if more space is required.)

Attached is a check payable to the City of Atmore in the amount of $25.00 for a filing fee plus $5.00 per lot or unit in the development. For a PUD, an additional fee of $2.00 per 1,000 square feet of non-residential land area is attached.

TOTAL $ ______________.

Signed _________________________
   (Name of Applicant or Agent)

ATMORE PLANNING COMMISSION
FINAL PLAT CHECKLIST

Subdivision Name ____________________________________ Date _____

1. ___ Application forms completed.

2. ___ Filing fees paid.

3. ___ Street sign fee paid.

4. ___ One (1) original reproducible mylar and eight (8) copies of plat submitted 15 days prior to meeting.

5. ___ Compliance with preliminary plat as approved and within one year of preliminary plat approval.

6. ___ Surety bond, if required, to guarantee installation of improvements.

7. ___ Final Plat requirements met.

a. ___ Name and address of owner and lienholder, name of subdivision, name and seal of registered land surveyor and/or registered engineer.

b. ___ Vicinity Map, date, north point and scale.

c. ___ Legal description.

d. ___ Location, bearing and length of every street line, lot line, boundary line and block line.

e. ___ Names of owners of record of adjoining land with appropriate acreage and streets.

f. ___ Total acreage of platted area.

g. ___ Streets, rights-of-way and street names.

h. ___ Location of easements for utilities and drainage facilities.

i. ___ Lot lines and lot and block numbers.

j. ___ Minimum building setback lines.

k. ___ Parks, school sites, or other public open spaces, if any.

l. ___ Zoning district boundaries, if such exist. Otherwise, proposed use of land restrictions on each lot in the subdivision. All restrictions must be recorded with plat.

m. ___ Endorsements, dedications and certificates:

___ Registered Surveyor.

___ Owner Dedication.

___ Notary Acknowledgement of Dedication.

___ Atmore Utilities Board.

___ City Engineer.

___ County Engineer.

___ County Health Department.

___ Atmore Planning Commission.

___ Probate Judge.

n. ___ Federal and State permits required for construction.

o. ___ Hold harmless agreement for damages caused by run-off from the development.

p. ___ "As built" plans and Certificate of Construction for Acceptance of a Subdivision.

APPLICATION FOR VARIANCE TO THE ATMORE SUBDIVISION REGULATIONS

This is to certify that I/we the undersigned do hereby request the Atmore Planning Commission to grant a Variance of the Subdivision Requirements of the City of Atmore as indicated below, and for the reasons stated:

1)

Name of Subdivision, Applicant's Name, Address and Phone:

 

 

 

2)

Article(s) and Section(s) for which Variance is requested:

Article            Section

 

 

 

3)

Nature of Variance requested:

 

 

 

4)

Reason for Request:

 

 

 

Dated this _____ day of ___________________, 20____.

	Owner, Subdivider or

Authorized Representative

SURVEYOR'S CERTIFICATE AND DESCRIPTION OF LAND PLATTED

STATE OF ALABAMA     )

COUNTY OF ____________  )

I, (name of surveyor), a registered Land Surveyor of ________________ County, Alabama, hereby certify that I have surveyed the property of the (name of company or proprietor), a (corporation or proprietor), situated in __________________ County, Alabama and described as follows:

(Insert Legal Description)

 

And that the plat or map contained hereon is a true and correct map showing the subdivision into which the property described is divided giving the length and bearings of the boundaries of each lot and easements and its number and showing the streets, alleys and public grounds and giving the bearings, length, width and name of the streets, said map further shows the relation of the land so platted to the Government Survey, and that permanent monuments have been placed at points marked thus (0) as hereon shown.

WITNESS my hand this the _______ day of ________________, 20___.

Signed: ______________________________
      (Name of Surveyor)

Registration # _______________

DEDICATION

I/We (Land owner or developer, address), as proprietor(s), have caused the land embraced in the within plat to be surveyed, laid out and platted to be known as (Subdivision Name), a part of (Section Call Out), Escambia County, Alabama, and that the (Streets, Drives, Alleys, Easements, etc.) as shown on said plat are hereby dedicated to the use of the public.

Signed and sealed in the presence of:

______________________________  ______________________________
Witness              Property Owner

______________________________  ______________________________
Witness              Property Owner

ACKNOWLEDGEMENT

STATE OF ALABAMA   )
)
COUNTY OF _________  )

I, __________________________, Notary Public in and for said County, in said State, hereby certify that (individual's name), whose name as (title) of the (corporation name), is signed to the foregoing instrument, and who is known to me, acknowledged before me on this day that, being informed of the content of the instrument, and as such officer and with full authority, executed the same voluntarily for and as the act of said corporation.

GIVEN under my hand and official seal this _______ day of _______________, 20___.

	NOTARY PUBLIC

 

ACKNOWLEDGEMENT

STATE OF ALABAMA   )
)
COUNTY OF _________  )

I, __________________________, a Notary Public in and for said County, in said State, hereby certify that (owner's name), whose name is signed to the foregoing instrument, and who is known to me, acknowledged before me on the day that, being informed of the contents of the instrument, executed the same voluntarily.

GIVEN under my hand and official seal this _______ day of ________________, 20 ____.

	NOTARY PUBLIC

CERTIFICATE OF APPROVAL BY THE ATMORE UTILITIES BOARD

The undersigned, as authorized by the Atmore Utilities Board hereby approved the within plat for the recording of the same in the Probate Office of Escambia County, Alabama, this the _____ day of ______________, 20____.

	Manager

 

CERTIFICATION OF THE APPROVAL OF STREET AND UTILITIES

I hereby certify: (1) that streets, utilities, and other improvements have been installed in an acceptable manner according to City specifications in the subdivision entitled _______________________ or, (2) that a security bond in the amount of $ _________________ has been posted with the Atmore City Council to assure completion of all required improvements in case of default.

______________________________, 20____.

	City Engineer

CERTIFICATE OF APPROVAL BY THE COUNTY ENGINEER

The undersigned, as County Engineer of Escambia County, Alabama, hereby approved the within plat for the recording of same in the Probate Office of Escambia County, Alabama, this the _____ day of _____________, 20____.

	County Engineer

 

CERTIFICATE OF APPROVAL BY THE ESCAMBIA COUNTY HEALTH DEPARTMENT

The undersigned, as authorized by the Escambia County Health Department, hereby approved the within plat for the recording of same in the Probate Office of Escambia County, Alabama, this the _____ day of _________________, 20____.

	Health Officer

CERTIFICATE OF APPROVAL BY THE ATMORE PLANNING COMMISSION

The within plat of _____________________ subdivision in Escambia County, Alabama, is hereby approved by the Atmore Planning Commission of the City of Atmore, Alabama, this the _______ day of ________________, 20____.

	Chairman

 

OFFICE OF JUDGE OF PROBATE

STATE OF ALABAMA   )
COUNTY OF ESCAMBIA  )

I hereby certify that this Plat or Map was filed in this office for record this __________ day of _________________, 19 ______, at ________ O'Clock __M., and recorded in Book ________________ of Plats and Maps, Page __________.

	Judge of Probate

CERTIFICATE OF CONSTRUCTION FOR
ACCEPTANCE OF A SUBDIVISION IN ATMORE, ALABAMA
(TO BE FILED WITH "AS BUILT" ENGINEERING PLANS)

I, _______________________, a professional engineer registered in the State of Alabama, Registration Number ____________, do hereby certify that the streets and drainage system for _________________________________________ subdivision have been constructed under my supervision in accordance with the construction plans approved by the City Engineer.

I further certify that I have checked all test reports and that all base material, concrete, and asphalt have been installed in accordance with the typical sections, profiles, and plan details and meet minimum requirements as set out in the City of Atmore's Standard Specifications for Design and Construction of Roadway and Drainage Improvements, latest Edition and current revisions.

I acknowledge that in the event that the certification given herein shall be determined by the City to be grossly incorrect the City may thereafter refuse to accept the certification of the undersigned.

NAME __________________
P.E. # __________________
DATE __________________
TITLE __________________
FIRM __________________