(A)

Certificate of ownership. (For use with minor plats only.)

I (We) hereby certify that I am (we are) the owner(s) of the property described hereon, which property is within the subdivision regulation jurisdiction of the City of Shelby, and that I (we) freely adopt this plan of subdivision. I (We) further certify that the residual tract on this plan cannot be further subdivided using the minor subdivision plat approval process within two years of the date of recordation.

(B)

Certificate of ownership and dedication. (For use with major plats only.)

I (We) hereby certify that I am (we are) the owner(s) of the property described hereon, which property is located within the subdivision regulation jurisdiction of Shelby, that I (We) hereby freely adopt this plan of subdivision and dedicate to public use all areas shown on this plat as streets, alleys, walks, parks, open space, and easements, except those specifically indicated as private, and that I (we) will maintain all such areas until the offer of dedication is accepted by the appropriate public authority. All property shown on this plat as dedicated for a public use shall be deemed to be dedicated for any other public use authorized by law when such other use is approved by the City Council of the City of Shelby in the public interest.

(C)

Certificate of minor plat approval.

I hereby certify that the minor subdivision shown on this plat does not involve the creation of new public streets or any change in existing public streets, that the subdivision shown is in all respects in compliance with the Shelby Unified Development Ordinance, and that therefore this plat has been approved by the Shelby UDO Administrator, subject to its being recorded in Office of the Register of Deeds within thirty days of the date below.

(D)

Certificate of preliminary plat approval.

I hereby certify that the Planning and Zoning Board of the City of Shelby approved on the _______ day of ________, _______ the Preliminary Plat of subdivision as shown on this plat. Preliminary Plat approval is valid for a period of 12 months from the above date or as established under the vested rights procedures, if applicable.

(E)

Certificate of final plat approval.

I hereby certify that the subdivision depicted hereon has been granted final approval pursuant to the Shelby Unified Development Ordinance subject to its being recorded in the Office of Register of Deeds within thirty days of the date below.

(F)

Certificate of approval of required improvements.

I hereby certify that streets, utilities and other improvements have been installed in an acceptable manner and according to the City specifications in the subdivision depicted hereon or that a performance bond or other sufficient surety in the amount of $_____ has been posted with Shelby to assure completion of required improvements.

I hereby certify that a guarantee in-lieu of the installation of the required improvements in an amount or manner satisfactory to the City of Shelby has been received.

(G)

Certificate of survey and accuracy.

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 NCGS 47-30 as amended. Witness my original signature, registration number and seal this ___ day of _______, A.D., _______.

Seal or Stamp of Surveyor

(H)

Division of highways district engineer certificate.

I hereby certify that the streets as depicted hereon are/are not consistent with the requirements of the North Carolina Department of Transportation.

(I)

Private streets disclosure statement.

The following statement shall be placed on all subdivision plats which include private streets:

"The maintenance of streets designated on this plat as 'private' shall be the responsibility of property owners within this development having access to such streets. Private streets as shown hereon were not constructed to the minimum standards required to allow their inclusion, for maintenance purposes, on the North Carolina highway system nor for maintenance by the City of Shelby. Neither the City of Shelby nor the North Carolina Department of Transportation will maintain a private street."

(J)

Certification of the county health department.

I hereby certify that lots shown on this plat for ___________ subdivision have been preliminarily determined as generally or provisionally suitable for septic tanks. Final approval of individual lots is subject to the lot size, a soils evaluation and proper drainage and filling requirements

(K)

Utilities certificate.

I hereby certify that the ___________ improvements have been installed in an acceptable manner and in accordance with the requirements of the Shelby Unified Development Ordinance.

(L)

Public water supply watershed protection statement.

The following statement shall be placed on all subdivision plats which include property located within a watershed protection overlay district:

"All or portions of the property contained in this subdivision are located within a Public Water Supply Watershed. Additional development restrictions regarding such matters as residential density, maximum impervious surface area, and stormwater control measures may apply to this property. Any engineered stormwater controls shown on this plat are to be operated and maintained by the property owners and/or a property owners' association pursuant to the Operation and Maintenance Agreement filed with the Office of the County Register of Deeds in Book _______ Page _______."

(M)

Certificate of purpose of plat.

The final plat shall contain one of the following statements, signed and sealed by the plat preparer:

a.

This survey creates a subdivision of land within the area of a county or municipality that has an ordinance that regulates parcels of land;

b.

This survey is located in a portion of a county or municipality that is unregulated as to an ordinance that regulates parcels of land;

c.

Any one of the following:

1.

This survey is of an existing parcel or parcels of land and does not create a new street or change an existing street;

2.

This survey is of an existing building or other structure, or natural feature, such as a water course;

3.

This survey is a control survey;

d.

This survey is of another category, such as the recombination of existing parcels, a court-ordered survey, or other exception to the definition of subdivision; or

e.

The information available to the surveyor is such that the surveyor is unable to make a determination to the best of the surveyor's professional ability as to provisions contained in (a) through (d) above.

(N)

Certificate of exception.

Plats deemed to be an exception to the provisions of this Ordinance shall contain the following statement prior to the owner's recording of such plats:

I (We) hereby certify that I am (we are) the owner(s) of the property shown and described hereon, which was conveyed to me (us) by deed recorded in Book _______, Page _______, and that said property qualifies as an exception to the provisions of the Shelby Unified Development Ordinance.

(O)

Acknowledgment of recordation of nonevaluated/nonbuildable lot(s).

The following statement may be utilized in those situations in which heir property is subdivided or whenever a property owner wishes to record property that is not to be sold, transferred, conveyed or represented as a buildable property:

I (We) the undersigned property owners do hereby acknowledge that the plat entitled ___________________ and dated ___________ has _______ lot(s) that has (have) not been evaluated by the County Health Department and has (have) been determined to be NONBUILDABLE by the Shelby Planning Services Department.

I (We) further understand that this plat can be recorded; however, no structure can be permitted without further review and approval of the County Health Department and the Shelby Planning Services Department.

Signed by:

Witness: