1. A.
   One (1) copy of the County Assessor’s map showing all area within six hundred sixty (660) feet of subject property and depicting all area therein owned by the applicant.

2. B.

   One (1) copy of the recorded deed reflecting current ownership and description of property, or one (1) copy of any other document which shows such ownership to the satisfaction of the City Attorney.

4. C.
   Parcel Map Contents:

1. 1.

   Owner’s Certificate, including the granting of easements and dedication of alleys, streets, highways or other public ways as shown on the map (per Appendix E);

2. 2.
   Certificate of land surveyor, signed and sealed by the professional land surveyor who was responsible for the survey (per Appendix E);

3. 3.
   All monuments found, set, reset, replaced or removed, describing kind, size and location and other data relating thereto;

4. 4.
   Bearing or witness monuments, basis of bearings, bearing and length of lines and scale of map;

5. 5.
   Name and legal description of tract in which survey is located and ties to adjoining tracts;

6. 6.
   Existing easements granted or dedications made within one hundred fifty (150) feet of the parcel boundaries, if applicable;

7. 7.
   Street names, location and width of existing and proposed rights-of-way to serve as access for the parcels, up to a minimum of one hundred fifty (150) feet from boundary of proposed division, and access streets connecting development to existing dedicated streets;

8. 8.
   Where applicable, proposed street names and addresses for each lot, in accordance with the City's street addressing regulations;

9. 9.
   Survey analysis sufficient to delineate boundary controlling monuments;

10. 10.
    Identification of adjoining properties;

11. 11.
    A legend, as necessary, which denotes the meaning of all symbols utilized and includes the date and north arrow;

12. 12.
    Dimensions of property and parcels to be created, which shall be shown in acres, calculated to the nearest one hundredth (0.01) of an acre, if an area is two (2) acres or more, or in square feet if area is less than two (2) acres;

13. 13.

    All existing structures and other physical features that have bearing on the proposed division, which shall be shown to scale and with setbacks clearly defined;

14. 14.
    Certificate of approval by the Director of Community Development and the City Surveyor;

15. 15.
    Impact Statement, if required;

16. 16.
    Location of all trails.

5. D.
   Supplemental Information

1. 1.
   All off site improvements proposed by the applicant that have a bearing on the proposed division; and

2. 2.
   Certification by a surveyor that the parcel map complies with NRS Chapter 278, if the City Surveyor has waived the requirement for a new survey and the map is prepared from a previously recorded survey.

1. A.
   Tentative Map Contents

1. 1.
   Name of the proposed subdivision.

2. 2.
   Names, addresses and phone numbers of owner, subdivider and surveyor or engineer.

3. 3.
   A legend which denotes the meaning of all the symbols used and which includes the date, north arrow and scale.

4. 4.
   A location map giving sufficient legal description to describe tract boundaries and relationships to surrounding areas and existing public streets.

5. 5.
   Identification of adjoining properties.

6. 6.
   Existing topography (obtained by actual survey at one (1) foot contours (based on city datum) on-site and within one hundred fifty (150) feet of the proposed subdivision (except for the interior of existing subdivisions within one hundred, fifty (150) feet). The Department of Public Works may require larger contour intervals for large tracts.

7. 7.
   Existing structures and other physical features.

8. 8.
   Existing and proposed lot lines and dimensions. Each proposed lot shall be numbered in sequence. Letters may be used to identify common lots.

9. 9.
   Existing and proposed street right-of-way widths, grades (with the direction of drainage indicated) and corner radii.

10. 10.
    Existing and proposed street names.

11. 11.
    Except for commercial subdivisions, existing and proposed street addresses or address ranges' for each block, in accordance with the City's street addressing regulations.

12. 12.
    Locations and widths of existing and proposed utility rights-of-way and easements.

13. 13.
    Locations and widths of existing and proposed irrigation or drainage ditch rights-of-way and easements.

14. 14.
    Existing and proposed storm drains.

15. 15.
    Proposed sanitary sewer systems, showing pipe sizes, manholes, direction of flow and point of connection to existing facilities.

16. 16.
    Existing and proposed potable water mains and, for subdivisions to be supplied by wells, the location, pressure and capacity of such wells, and the potential population capable of being served by such wells. The wells must be authorized under State certificate.

17. 17.
    Proposed reservations or dedications for parks, trails, open spaces, schools, or other public or quasi-public uses.

18. 18.
    Existing street names, rights-of-way and pavement widths for streets within one hundred fifty (150) feet of the proposed subdivision.

19. 19.
    If required, an Impact Statement in accordance with LVMC 19.16.010(F) and a Traffic Management Plan.

20. 20.
    Note on the map indicating whether streets, drainage corridors, sewer corridors, parks, trails, open spaces and schools are to be public or private.

21. 21.
    Note on the map that above ground utility boxes shall not be placed within trail corridors, if trail areas are designated on the map.

2. B.
   Supplemental Information

1. 1.
   A Traffic Impact Analysis, Single Subdivision Access Report, or Master Driveway and Onsite Circulation Plan, prepared in accordance with City standards or as directed by the City Traffic Engineer.

2. 2.
   Development Impact Notice and Assessment (DINA) per Section 19.16.010(F) of the Unified Development Code.

3. 3.
   Any proposed deviations from City standards.

4. 4.
   A copy of the deed for the property, if required.

5. 5.
   Whenever, on the perimeter of a project, walls are proposed which (1) face a public street or adjoining property not in common ownership; (2) are within a single plane and are not separated by landscaping; and (3) exceed the maximum acceptable wall heights indicated in the Unified Development Code, the applicant shall submit three copies of a plan or proposed perimeter grades which indicates all such walls. This plan may be superimposed on the tentative map but must be legible. The plan shall include cross sections of all sections of the project perimeter with walls which exceed the heights indicated in Table "A".

6. 6.
   A compatible digital format copy of the tentative map.

6. 7.
   If applicable, a letter indicating that an in-lieu-of park is proposed.

1. A.
   Final Map Contents

1. 1.
   Name of proposed subdivision (which should include designation, if applicable, as a condominium, townhouse, residential planned development, commercial subdivision, or mixed use commercial/residential condominium development).

2. 2.
   A legend which denotes the meaning of all the symbols used and which includes the date, north arrow and scale.

3. 3.
   Identification of adjoining properties.

4. 4.
   A survey analysis sufficient to delineate boundary controlling monuments.

5. 5.
   Existing and proposed lot lines and dimensions, including the square footage of all proposed lots. Each lot shall be numbered in sequence. Letters may be used to identify common lots.

6. 6.
   Existing and proposed street right-of-way widths and corner radii.

7. 7.
   If an amend map, a description of items being amended.

8. 8.
   A reproduction of the approved tentative map showing all proposed addresses for the tentative map.

9. 9.
   A list, separate from the final map, of proposed addresses for every legal lot shown on the final map.

10. 10.
    Locations and widths of existing and proposed utility rights-of-way and easements.

11. 11.
    Locations and widths of existing and proposed irrigation or drainage ditch rights-of-way and easements.

12. 12.
    All monuments found, set, reset, replaced or removed, describing kind, size and location and other data relating thereto.

13. 13.
    Bearing or witness monuments, basis of bearings, bearing and length of lines and scale of map.

14. 14.
    Name and legal description of tract in which survey is located and ties to adjoining tracts.

15. 15.
    Note on the map whether streets, drainage corridors, sewer corridors, parks, trails, open spaces and schools are to be public or private.

16. 16.
    Note on the map that above ground utility boxes shall not be placed within trail corridors, if trail areas are designated on the map.

16. 17.
    Note on the map referring to the latest approved construction improvement plans regarding Sight Visibility Restriction Zones (SVRZ). If a separate exhibit is required by the City Traffic Engineer, reference to this recorded document shall be included on the final map.

2. B.
   Required Certifications

1. 1.
   Certificate of ownership and easement dedication. All final maps shall contain a certificate of ownership and easement dedication, dedicating easements and rights of way for alleys, streets, highways or other public ways as shown on the map.

2. 2.
   Certificate of land surveyor. All final maps shall be signed and sealed by the professional land surveyor who was responsible for the survey.

3. 3.
   Certificate of City Surveyor. All final maps shall be certified by the City Surveyor stating that the final map is technically correct and complies with City standards.

4. 4.
   Certificate of the Southern Nevada District Board of Health. All final maps shall be certified by the Southern Nevada District Board of Health that they comply with all requirements relating to wastewater disposal, water pollution, water quality and water supply and that they are predicated upon plans for public/private potable water supply and community/individual wastewater system.

5. 5.
   Certificate of Water Resources Division. All final maps shall be certified by the Division of Water Resources of the State Department of Conservation and Natural Resources as to their compliance with all water quantity requirements.

6. 6.
   Certificate of Director of Community Development/Planning Commission approval. All final maps shall be certified by the Director as to compliance with the approved tentative map, all applicable regulations and all conditions imposed upon the final map. No final map shall be filed with the County Recorder until it has been certified by the Director that he or she (or the Planning Commission) has approved the final map and accepted all rights of way, easements or parcels for public dedication.

7. 7.
   Certificate of easement recipients.

8. 8.
   Certificate of acknowledgment.

3. C.
   Supplemental Requirements

1. 1.
   Evidence that a Drainage Plan and Technical Drainage Study has been submitted in proper form to the Department of Public Works or that said study is not required.

2. 2.
   A copy of the deed attesting to the current ownership of the property.

3. 3.
   A statement from the Title Company which complies with the requirements of NRS Chapters 278 and 116 listing the names of the current owners of record of the land and the holders or record of a security interest in the land and the written consent of each.

4. 4.
   A copy of a sewer connection agreement verifying that downstream sewer capacity is available or that sewer capacity mitigation measures acceptable to the Department of Public Works will be provided.

4. D.
   Final Map Drawings

1. A.
   General Requirements

1. 1.
   These requirements apply to any parcel map, final map or record-of-survey, hereinafter referred to as the ‘subject map,’ prepared in conjunction with a survey performed within the City of Las Vegas or at the direction of the City of Las Vegas.
2. 2.
   Only a professional land surveyor, duly licensed by the State of Nevada, shall be authorized to establish the exact location for a survey monument or set a survey monument.
3. 3.
   Any monuments set by a professional land surveyor are to be memorialized by a record-of-survey per NRS 625.340, or a subdivision map per NRS 278.
4. 4.
   Monuments shall be set in conformance with all applicable Clark County Area Uniform Standard Drawings, approved maps and plans on file with the City of Las Vegas, and any other requirements listed herein.
5. 5.
   All monuments shall be set in such a manner that the accuracy of their relative positions is not less than the requirements of the “Standards of Practice for Professional Land Surveyors” as enumerated by Nevada Administrative Code (NAC), Sections 625.651 to 625.795, inclusive.

2. B.
   Monument Locations

1. 1.
   Monuments are required to be set at the standard corner locations listed below. Additional corner locations may be required for specific cases. Alternate monument locations require approval from the City Surveyor before monuments are set. All lines and corners associated with all monument locations shall be clearly delineated and identified on the subject map.

4. (1)

   Monuments shall not be set at any intersections of subdivision boundaries (or prolongations thereof) with street centerlines, unless requested by the City Surveyor. However, monuments shall be set at the intersection of the subdivision boundary with the adjacent right-of-way line.

5. Type III Alternative

A recessed non-ferrous metal 1-inch minimum diameter cap with a minimum 5/8-inch diameter stem shall be set at all Type III monument locations that fall in concrete improvements. Nails with tags or washers will not be accepted.

6. Type IV:

Four (4) reference monuments (RM’s) to be constructed per Standard Drawing No. 242 for all new Type I, Type II and Type III monuments, and meet the following requirements:

1. A.
   Owner's Certificate

1. 1.
   For residential subdivisions other than planned unit developments and condominium developments, the Owner’s Certificate shown on the final map shall be in substantially the following form, with necessary modifications consistent with project needs to be made by the owner or map applicant:

(I/We), _____________________, do hereby certify that (I/we) am/are the owner(s) of the parcel of land which is shown upon the plat of _____________________, do hereby consent to the preparation and recordation of this plat, and hereby : 

Furthermore, the undersigned owner(s) does/do hereby grant and convey to Nevada Power Company and Centurylink of Nevada, LLC (jointly and severally), Southwest Gas Corporation, Las Vegas Valley Water District, Cox Communications Las Vegas, Inc., and __________________ (any other utilities authorized to provide service) and to their respective successors and assigns: (i) a three-foot wide easement on all side property lines, exclusive of easements for drainage, sewer, trails, and all other public use easements; (ii) a three-foot wide easement from property line to meter panel to provide access for underground service; (iii) a five foot wide easement on all property lines that abut public and private streets, exclusive of easements for drainage, sewer, trails, and all other public use easements, to include access to above-ground transformer pads; and (iv) a two-foot wide easement around each transformer pad within the platted lands for the construction, maintenance, operation and final removal of street lights, fire hydrants, underground power, telephone, gas, water and cable television lines and appurtenances, together with the right of ingress thereto and egress therefrom.

Provided, however, that no above-ground utility vaults that would substantially interfere with the intended use of the trail corridor shall be allowed within any easements, corridors, or common lots designated as public multi-use trail easement areas, and no such easement right shall be granted to the above listed utility companies, nor any other parties, in conflict with this statement.

Use the following paragraph if development has Public Streets only:

Further, the undersigned owner(s) hereby grant(s) and convey(s) to the City of Las Vegas and to its successors and assigns a five-foot wide easement adjacent to all property lines where lots or common element areas abut public streets for purposes of placing public fire hydrants, public drainage facilities, public streetlights, traffic signals, conduits and appurtenances, and an additional easement of up to two feet in radius from each fire hydrant, public drainage facility, streetlight, traffic signal, conduit and appurtenance, to extend beyond the five-foot easement if necessary, together with the right of ingress to and egress from these easements.

Further, the undersigned owner(s) hereby grant(s) and convey(s) to the City of Las Vegas and to its successors and assigns a five-foot wide easement adjacent to all property lines where lots or common element areas abut private streets for purposes of placing public drainage facilities and appurtenances, and an additional easement of up to two feet in radius from each public drainage facility and appurtenance, to extend beyond the five-foot easement if necessary, together with the right of ingress to and egress from these easements.

2. 2.
   For commercial subdivisions, planned unit development and condominium developments, the Owner’s Certificate shown on the final map shall be in substantially the following form, with necessary modifications consistent with project needs to be made by the owner or map applicant:

___________________________, do hereby certify that I/we am/are the owner(s) of the parcel of land which is shown upon the plat of ____________ . ________ , do hereby consent to the preparation and recordation of this plat, and do hereby:

Offer and dedicate to the City of Las Vegas all the streets (except private streets) and the other public rights-of-way and places as indicated and outlined hereon, for the use of the public; and grant to the City of Las Vegas the easements, as indicated and outlined hereon, for the use of the public. No part of the parcels marked “Not a part of this subdivision” is offered for dedication.

Furthermore, the undersigned owner(s) does/do hereby grant and convey to Nevada Power Company and Centurylink of Nevada, LLC (jointly and severally), Southwest Gas Corporation, Las Vegas Valley Water District, Cox Communications, Las Vegas, Inc., and _________________________________ (any other utilities authorized to provide service) jointly and severally, and to their respective successors and assigns, a permanent easement within the area shown hereon as private streets, common areas and all areas not occupied by any building for the construction, maintenance, operation and final removal of streetlights, if any, and fire hydrants, underground power, telephone, gas, water and cable television lines and appurtenances, together with the right of ingress thereto and egress therefrom.

Next paragraph is to be used only if a trail is being granted or dedicated to the City:

Provided, however, that no above-ground utility vaults that would substantially interfere with the intended use of the trail corridor shall be allowed within any easements, corridors, or common lots designated as public multi-use trail easement areas, and no such easement right shall be granted to the above listed utility companies, nor any other parties, in conflict with this statement.

Further, the undersigned owner(s) hereby grant(s) and convey(s) to the City of Las Vegas and to its successors and assigns a permanent easement within the area shown hereon as private streets, common areas and all areas not occupied by any building, for the construction, maintenance, operation and final removal of public street lights, if any, traffic signals, conduits and appurtenances, and public fire hydrants, together with the right of ingress to and egress therefrom.

______________________________ , do hereby certify that I/we am/are the owner(s) of the parcel(s) of land which is/are shown within the boundary of this plat and do hereby consent to the preparation and recordation of this plat for the purpose of reverting to acreage the parcel(s) of land delineated hereon.

2. B.
   Surveyor’s Certificate

I, (name of surveyor), a Professional Land Surveyor licensed in the State of Nevada, certify that:

(Or)

The monuments depicted on the plat will be of the character shown and occupy the positions indicated by ___________ date certain to be determined by City personnel________ and an appropriate financial guarantee will be posted with the City before recordation to assure the installation of the monuments.

________________________________________     _______________________________________________

Name of Surveyor                                                            *License/Registration No. and Seal

*Map must be stamped and sealed prior to submittal to a government agency per NAC 625.610(4)

I, (name of surveyor), a Professional Land Surveyor licensed in the State of Nevada, certify that:

________________________________________     _______________________________________________

*Map must be stamped and sealed prior to submittal to a government agency per NAC 625.610(4)

3. C.
   Certificate of City Surveyor

I, ________________ (name) City Surveyor of the City of Las Vegas, do hereby certify that I have examined the final subdivision map of (name of subdivision) and I am satisfied that the map is technically correct.

(If monuments have not been set, the certificate must include the following statement:

Monuments have not been set, but a proper performance bond has been deposited to guarantee their setting on or before the ________ day of _____________ (date certain to be determined by City personnel).

(If a reversionary final map, no monument statement is needed)

___________________________

4. D.
   Certificate of Southern Nevada Health District

________________________________________________________________________

BY:                                                                                                                   Date

FOR THE SOUTHERN NEVADA HEALTH DISTRICT

(Print Name under Signature)

This final map is approved by the Division of Water Resources of the Department of Conservation and Natural Resources concerning water quantity, subject to the review of approval on file in this office.

BY:                                                                                                                   Date

FOR THE DIVISION OF WATER RESOURCES

(Print Name under Signature)

I certify that this final map substantially complies with the tentative map and any approved alterations thereto; that the map complies with applicable statutory and ordinance provisions; that all conditions imposed upon the final map have been met; and that the map was approved and the parcels herein were accepted for dedication by the Director of Planning and Development on the ______ day of______ , 20__ .

NAME

DIRECTOR OF COMMUNITY DEVELOPMENT

PLANNING DIVISION

CITY OF LAS VEGAS, NEVADA

I certify that the Director of Planning and Development, on the ___ day of _______ , 20 __ did approve this map, in accordance with NRS 278.010 to 278.630, inclusive, for the purposes of reverting to acreage the property described herein.

NAME

DIRECTOR OF COMMUNITY DEVELOPMENT

PLANNING DIVISION

CITY OF LAS VEGAS, NEVADA

BY:

Southwest Gas Corporation

_________________________________

_________________________________

BY:

Nevada Power Company, A Nevada Corporation, d/b/a NV Energy

_________________________________

_________________________________

BY:

Centurylink of Nevada, LLC

_________________________________

_________________________________

BY:

Cox Communications Las Vegas, Inc

_________________________________

_________________________________

BY:

Las Vegas Valley Water District

_________________________________

Language for Merger & Resubdivision Maps and Amended Maps:

BY THEIR SIGNATURES BELOW, THE HEREIN NAMED PUBLIC UTILITY COMPANIES DO HEREBY RELINQUISH ALL UTILITY EASEMENTS WITHIN THE BOUNDARY OF THE HEREIN PLATTED LANDS AS GRANTED PER THE RECORDED PLAT BEING AFFECTED AND LISTED DIRECTLY BELOW THE TITLE OF THIS PLAT. THESE EASEMENTS ARE RELINQUISHED IN FAVOR OF THE EASEMENTS GRANTED, DELINEATED AND APPROVED HEREON BY THIS PLAT.

BY THE SIGNATURE BELOW, THE CITY DOES HEREBY ACCEPT THE EASEMENTS GRANTED TO THE CITY AS DELINEATED AND APPROVED HEREON WITH THIS PLAT, UNLESS OTHERWISE NOTED.

________________________________________          _______________________________________

NAME                                                                                        Date

CITY ENGINEER

CITY OF LAS VEGAS

1. 1.
   The following certificate is sufficient for an acknowledgment in an individual capacity:

This instrument was acknowledged before me on (date) _____________ by name(s) of person(s).

_______________________

2. 2.
   The following certificate is sufficient for an acknowledgment in a representative capacity:

This instrument was acknowledged before me on (date) _____________ by name(s) of person(s).

_______________________

1. A.
   Owner's Certificate

________________________ do hereby certify that I/we am/are the owner(s) of the parcel of land which is shown hereon, do hereby consent to the preparation and recordation of this parcel map, have caused the land to be surveyed and platted into parcels, and do hereby:

Offer and dedicate to the City of Las Vegas all the streets (except private streets) and the other public rights-of-way and places as indicated and outlined hereon, for the use of the public; and grant to the City of Las Vegas the easements, as indicated and outlined hereon, for the use of the public.

Use the following paragraph if development has Public Streets only:

Further, the undersigned owner(s) hereby grant(s) and convey(s) to the City of Las Vegas and to its successors and assigns a five-foot wide easement adjacent to all property lines where lots abut public streets for purposes of placing public fire hydrants, public drainage facilities, public streetlights, traffic signals, conduits and appurtenances, and an additional easement of up to two feet in radius from each fire hydrant, public drainage facility, streetlight, traffic signal, conduit and appurtenance, to extend beyond the five-foot easement if necessary, together with the right of ingress to and egress from these easements

Or, use the following paragraph if development has Private Streets only:

Further, the undersigned owner(s) hereby grant(s) and convey(s) to the City of Las Vegas and to its successors and assigns a five-foot wide easement adjacent to all property lines where lots abut private streets for purposes of placing public drainage facilities and appurtenances, and an additional easement of up to two feet in radius from each fire hydrant, streetlight, traffic signal, conduit and appurtenance to extend beyond the five-foot easement if necessary, together with the right of ingress to and egress from these easements.

Dated this______________________ day of 20____ .

_________________________ , do hereby certify that I/we am/are the owner(s) of the parcel(s) of land which is/are shown within the boundary of this map and do hereby consent to the preparation and recordation of this map for the purpose of reverting to acreage the parcel(s) of land delineated hereon.

I, (name of surveyor) , a Professional Land Surveyor licensed in the State of Nevada, certify that:

(Or)

The monuments depicted on the plat will be of the character shown and occupy the positions indicated by ___________ date certain to be determined by City personnel________ and an appropriate financial guarantee will be posted with the City before recordation to assure the installation of the monuments.

_________________________________________            ______________________________________

Name of Surveyor                                                                     *License/Registration No. and Seal

*Map must be stamped and sealed prior to submittal to a government agency per NAC 625.610(4)

I, (name of surveyor), a Professional Land Surveyor licensed in the State of Nevada, certify that:

_________________________________________            ______________________________________

Name of Surveyor                                                                     *License/Registration No. and Seal

*Map must be stamped and sealed prior to submittal to a government agency per NAC 625.610(4)

I,___________________(name) , City Surveyor of the City of Las Vegas, do hereby certify that I have examined the parcel map (or reversionary parcel map) and am satisfied that the map is technically correct.

(If monuments have not been set in the case of a parcel map the certificate must include the following statement:)

Monuments have not been set, but a proper performance bond has been deposited to guarantee their setting on or before ___________ (date certain to be determined by City personnel) .

(If a reversionary map, no monument statement is needed)

_________________________         __________

City Surveyor, PLS                                 Date

I certify that this parcel map was approved and the parcels herein were accepted for dedication by the Director of Community Development on the____ day of ______ , 20 ___ .

________________________________________________________________________

NAME

DIRECTOR OF COMMUNITY DEVELOPMENT

PLANNING DIVISION

CITY OF LAS VEGAS, NEVADA

I certify that the Director of Community Development, on the____ day of ____________ , 20____ , did approve this map, in accordance with NRS 278.010 to 278.630, inclusive, for the purposes of reverting to acreage the property described herein.

NAME

DIRECTOR OF COMMUNITY DEVELOPMENT

PLANNING DIVISION

CITY OF LAS VEGAS, NEVADA

This instrument was acknowledged before me on (date) _____________ by name(s) of person(s).

_______________________

The Owner’s Certificate shown on the record-of-survey map shall be in substantially the following form, with necessary modifications consistent with project needs to be made by the owner or map applicant:

__________________________and__________________________ _do hereby certify that we are the owners of the lands shown hereon, that we have caused a boundary line adjustment survey to be performed as indicated hereon, and that we have examined and approved this map and consent to and authorize its recordation. Further, we agree:

To prepare and execute the required documents creating any and all easements as shown hereon and to execute all required documentation abandoning any existing easements affecting the lands shown pursuant to the provisions of NRS 278.010 through 278.630, inclusive; and

That all taxes on the lands shown hereon have been paid, and all lenders, impound account holders for payment of taxes, or both, have been notified of the adjustment of the boundary line or the transfer of the lands shown hereon.

Dated this______________________ day of 20____.

_________________________________________            ______________________________________

*Map must be stamped and sealed prior to submittal to a government agency per NAC 625.610(4)

This map has been approved for the purpose of achieving a boundary line adjustment in accordance with the provisions of NRS 278.010 to 278.630, inclusive on this_____ day of

_________20____ .

City Surveyor, PLS                                 Date

This instrument was acknowledged before me on (date) _____________ by name(s) of person(s).

(Signature of notarial officer)

_______________________

This instrument was acknowledged before me on (date) _____________ by name(s) of person(s).

_______________________