Plat/Plan Certifications

Form A

Final Subdivision Plat and Construction Plans

CERTIFICATION OF THE APPROVAL OF PRIVATE SEWERAGE SYSTEMS

I hereby certify that the private sewage disposal system installed, or proposed to be installed in the development entitled: ______________________ (name of development) fully meets the requirements of the Kentucky State Health Department and hereby is approved as shown.

________________(date), 20___

___________________________________
(County Health Department official)

Form B (amended)

Preliminary Subdivision Plat and Final Development Plan

CERTIFICATION OF THE PROVISION OF WATER ONLY

I hereby certify that Georgetown Municipal Water & Sewer Service (GMWSS) has the capacity within the water distribution system to supply ________________________ with water services. Provision of service will be contingent upon the review and approval of all on-site and off-site plans and specifications for the proposed system. Construction of the water distribution system to be by/at the cost of the developer without reimbursement, built to GMWSS approved specifications and approval by GMWSS of the as-built improvements and hereby dedicated to GMWSS.

________________ Date

_______________________________
General Manager

Form C (amended)

Final Subdivision Plat

CERTIFICATION OF PROVISION OF WATER SERVICE

I hereby certify that Kentucky American has reviewed the plans and specs for the proposed water distribution system for __________________________ (name of development), that the water distribution system of said development meets the requirements of this agency and all other requirements of the proper distribution of water, and that Kentucky American shall supply said development with water services.

__________________ 20 ___

_______________________________
General Manager

Form D (amended)

Final Subdivision Plat and Final Development Plan

CERTIFICATION OF THE PROVISION OF SEWER ONLY

I hereby certify that Georgetown Municipal Water & Sewer Service (GMWSS) has the capacity within the sewer collection system to supply ________________________ with sewage disposal services. Provision of service will be contingent upon the review and approval of all on-site and off-site plans and specifications for the proposed system. Construction of the sewer collection system to be by/at the cost of the developer without reimbursement, built to GMWSS approved specifications and approval by GMWSS of the as-built improvements and hereby dedicated to GMWSS.

________________ Date

_______________________________
General Manager

Form E (amended)

Preliminary Subdivision Plat and Final Development Plan

CERTIFICATION OF WATER & SEWER SERVICES

I hereby certify that Georgetown Municipal Water & Sewer Service (GMWSS) has the capacity within the water distribution system/sewer collection system to supply ________________________ with water services/sewage disposal services. Provision of service will be contingent upon the review and approval of all on-site and off-site plans and specifications for the proposed system. Construction of the water distribution system/sewer collection system to be by/at the cost of the developer without reimbursement, built to GMWSS approved specifications and approval by GMWSS of the as-built improvements and hereby dedicated to GMWSS.

________________ Date

_______________________________
General Manager

Form F

Preliminary and Final Subdivision Plat and Development Plans

CERTIFICATION OF OWNERSHIP AND DEDICATION

I (we) hereby certify that I am (we are) the owner(s) of the property shown and described hereon and that I (we) hereby adopt this plat/plan of the development with my (our) free consent, establish the minimum building restriction lines, and dedicate all streets, alleys, walks, parks, and other open spaces to public or private use as shown, in accordance with the Georgetown-Scott County Subdivision and Development Regulations, unless otherwise noted.

For all Final Development Plans add the following "Standard Requirements" after the above paragraph.

  1. Site shall be constructed and maintained in accordance with this plan. Any deviation from the plan, including landscaping, shall first be approved by the Planning Director and the Commission Engineer. Major modifications of the plan shall first be approved by the Planning Commission.

  2. Storm drainage facilities, including retention basins, shall be maintained for proper functioning free of any debris, silt, or trash.

  3. A Certificate of Occupancy shall not be issued and the buildings shall not be occupied until all site improvements shown on the Final Development Plan and listed in these conditions are installed. Required landscaping unable to be installed due to extreme weather conditions may be secured for a period of one year by submitting to the Planning Director an approved security for 125% of the cost of the total work to be done, as substantiated by cost estimates approved by the Planning Director.

  4. There shall be no grading or construction until the Final Development Plan has been approved and signed by the Planning Commission, except as construction drawings are approved by the Planning Director for site development. The building permit shall not be issued until the Final Development Plan is approved and signed.

____________________ (date), 20___

_______________________________
(owner or owners)

Form G

Preliminary and Final Subdivision Plat

CERTIFICATE OF ACCURACY

I hereby certify that the plan shown and described hereon is a true and correct survey to the accuracy required by the Georgetown-Scott County Planning Commission and that the monuments have been placed as shown herein to the specifications of the Planning Commission or other authorized officer.

____________________ (date), 20___

_______________________________
(registered engineer or surveyor)

Form H

Attached to Construction Plans and Development Plans if Applicable

CERTIFICATION OF THE REVIEW OF STREET AND DRAINAGE PLANS

I hereby certify that the plans and profiles for the streets, stormwater management plans and other improvements for ________________________ (name of development) have been reviewed and are proposed in an acceptable manner according to the Subdivision and Development Regulations specifications.

____________________ (date), 20___

_______________________________
Commission Engineer

Form I

Attached to Preliminary Plat Only

CERTIFICATION OF PRELIMINARY PLAT APPROVAL

I hereby certify that the preliminary subdivision plat shown hereon has been found to comply with the Subdivision and Development Regulations for Georgetown and Scott County, Kentucky, with the exception of such variances, if any, as are noted in the minutes of the Planning Commission. Upon certification of the Commission Engineer of the approval of the water quality protection plan and all construction plans, construction may begin.

____________________ (date), 20___

_______________________________
Chairman, Georgetown-Scott County Planning Comm.

Form J

Attached to Preliminary Plan Only

CERTIFICATION OF PRELIMINARY PLAN APPROVAL

I hereby certify that the preliminary development plan shown hereon has been found to comply with the Subdivision and Development Regulations for Georgetown and Scott County, Kentucky, with the exception of such variances, if any, as are noted in the minutes of the Planning Commission.  This approval does not constitute approval to begin construction or obtain a building permit.

____________________ (date), 20___

_______________________________
Chairman, Georgetown-Scott County Planning Comm.

Form K

Attached to Final Subdivision Plats

CERTIFICATION OF THE APPROVAL OF STREETS AND DRAINAGE

I hereby certify: (1) that streets, stormwater management facilities and other improvements have been installed in an acceptable manner and according to city/county specifications in the development entitled:_____________________________________ or, (2) that security has been posted with the legislative body of ___________________________, Kentucky (a) in the amount of $______________ to assure completion of all required improvements in case of default, and (b) for Warranty and Maintenance Security in the amount of $___________________ as a guarantee of improvements until after public acceptance.

____________________ (date), 20___

_______________________________
Commission Engineer

Form L

Final Development Plans and Final Subdivision Plats - One Form Needed for Each Applicable Utility

CERTIFICATION OF AVAILABILITY OF UTILITY SERVICES

I hereby certify that ___________________ (name of agency or company) shall supply the ___________________ (name of development) with electric/gas/telephone services and that the proposed utility easements of said development meet the requirements of this agency and all other applicable requirements.

____________________ (date), 20___

_______________________________
Company representative (title)

Form M (amended)

CERTIFICATION OF ENVIRONMENTALLY SENSITIVE AREA NOTICE

I hereby certify that the environmentally sensitive areas as defined in Article XII, Section 1200. G, have been identified and shown on this plat. For areas including sinkholes, springs, and other related features, a study was performed including an analysis of these features noting any non-buildable areas and, where permitted, any remediation methods, techniques and materials that were implemented and inspected in accordance with that analysis. A copy of this analysis and related documents has been submitted to the Planning Commission for their records.

_______________________________
Registered Engineer/Geotechnical Engineer/Certified Geologist

Form N

Final Subdivision Plat

CERTIFICATION OF FINAL SUBDIVISION PLAT APPROVAL

I hereby certify that the subdivision plat shown hereon has been found to comply with the Subdivision and Development Regulations for Georgetown and Scott County, Kentucky, with the exceptions of such variances, if any, as are noted in the minutes of the Planning Commission and that it has been approved for recording in the office of the County Clerk.

____________________ (date), 20___

_______________________________
Chairman, Georgetown-Scott County Planning Comm.

Form O

Final Development Plan

CERTIFICATION OF FINAL DEVELOPMENT PLAN APPROVAL

I hereby certify that the development plan shown hereon has been found to comply with the Subdivision and Development Regulations for Georgetown and Scott County, Kentucky, with the exceptions of such variances, if any, as are noted in the minutes of the Planning Commission and that it has been approved for construction and obtaining building permits.

____________________ (date), 20___

_______________________________
Chairman, Georgetown-Scott County Planning Comm.

Form P

Final Subdivision Plat or Development Plan

DRAINAGE EASEMENT DESCRIPTION

Drainage easements contain stormwater channels, stormwater storage areas/facilities, and access rights for maintenance of such facilities. No channel alteration or construction that would obstruct the flow of stormwater is allowed. There shall be no storage or disposal of grass clippings, trash, debris, or other potential obstructions that may wash into stormwater channels or storage areas.

(The drainage easement description shall also specify maintenance responsibilities.)

Form Q (amended)

Final Subdivision Plat and Development Plans

CERTIFICATION OF UTILITY EASEMENT DESCRIPTION

Easements grant and convey to the Kentucky Utility Company, South Central Bell, Georgetown Municipal Water & Sewer Service (GMWSS), their successors, assigns, and lessees, the right to trim or remove any and all trees, structures and obstacles located on the easements or in such proximity thereto that in falling they might interfere with operation and maintenance of said facility. No building or other structure shall be erected, and no landfill or excavation or other change of grade shall be performed, upon the said easement after installation of facilities. The right of ingress and egress is hereby granted to users of the utility easement as required to construct, operate, maintain and reinforce facilities within said easements. All lots lines not having an easement indicated will have 5‘ easements on them.

________________ Date

_______________________________
Owner

Form R

Final Development Plan and Final Subdivision Plat

CERTIFICATION OF FIRE DEPARTMENT APPROVAL

I hereby certify that the development plan shown hereon has been reviewed and found to comply with the (insert either Georgetown or Scott County) Fire Department regulations, including any conditions of approval or exceptions, noted hereon.

____________________, 20___

_______________________________
(Signature and title of Fire Dept. representative)

Form S (amended)

Final Subdivision Plat

CERTIFICATION OF GMWSS INFRASTRUCTURE

The ownership of water lines, sewer lines, force mains, pump stations, and appurtenant structures thereto, existing or installed, and located within easements shown hereon are hereby dedicated to the City of Georgetown, by and through the Georgetown Municipal Water & Sewer Service (GMWSS) for operation. For a period of one (1) year following recording of this plat with Scott County Clerks Office, any and all maintenance costs incurred by GMWSS as a result of faulty equipment or installation will be invoiced to the developer for reimbursement to GMWSS.

________________ Date

_______________________________
Owner

Form T

Transfer and Consolidation Plats, Including any Final Plats

EASEMENT RELEASE

I hereby certify that there are no recorded or accrued utility and drainage easements being eliminated by this consolidation.

______________________________________
Signature and License Number of Surveyor or Engineer

-or-

Release of Easements: Except as noted or shown on this plat, the following parties hereby consent to the release of all rights that may have accrued for their use and benefit in the utility and drainage easements along the original lot lines eliminated by this plat, on the condition that new utility and drainage easements are provided along the new property lines.

______________________________________
County/City Engineer (as applicable)

______________________________________
Water (Signature)

______________________________________
Sewer (Signature)

______________________________________
Power (Signature)

______________________________________
Telephone (Signature)

______________________________________
Gas (Signature)

______________________________________
Cable TV (Signature)

Form U

Final Development Plans and Final Subdivision Plats, Including Minor Plans and Plats

CERTIFICATION OF GEORGETOWN DEVELOPMENT AUTHORITY APPROVAL

*Only applies to projects in business park*

I hereby certify that the development plan or subdivision plat shown hereon has been reviewed and found to comply with the Georgetown Development Authority guidelines, including any conditions of approval or exceptions, noted hereon.

____________________, 20___

_______________________________
Development Authority Chairperson

Form V

Final Subdivision Plats in Georgetown

CERTIFICATION OF STREET LIGHT APPROVAL

I hereby certify that $_____________ has been deposited with the City Engineer‘s office to assure completion of street lights for _____________________________________________ (name of development) in the case of default.

____________________, 20___

_______________________________
City Engineer

_______________________________

City Clerk

Form W

Final Subdivision Plats and Final Development Plans

CERTIFICATION OF GIS DEPARTMENT APPROVAL

I hereby certify that the development plan or subdivision plat shown has been reviewed and found to comply with the digital submittal requirements set forth in the Subdivision and Development Regulations.

____________________, 20___

_______________________________
GIS Analyst/Technician, Georgetown-Scott County Planning Commission

Form X

Final Subdivision Plats and Final Development Plans

PRIVATE STREET/ACCESS EASEMENT MAINTENANCE NOTE

The owner/owners of this property and any successors in title agree to assume full liability and responsibility for construction, maintenance, reconstruction, snow removal, cleaning or any other needs related to the private street/access easement shown on this development plan/plat. This agreement relieves the City of Georgetown/City of Stamping Ground/City of Sadieville/Scott County government from any such responsibilities. If the owner/owners request that the private street/access easement be dedicated as public streets, the owner/owners bear the full expense of any reconstruction required to comply with City/County standards prior to dedication and acceptance and all conditions outlined in SECTION 4, D. have been met.

_________________________________
Owner

_________________________________
Owner

Form Y

Preliminary and Final Subdivision Plats, Preliminary and Final Development Plans, and Construction Plans

REQUIRED NOTES:

  1. Residential Uses:

    1. "Any sinkhole related non-buildable area identified here has been determined to be unsuitable for any construction activity and no buildings, parking areas or other structures shall be permitted within this area."

    2. "Residential structures located adjacent to the closed contour of a sinkhole or adjacent to an immediate sinkhole drainage area shall not be permitted to have a basement or first floor elevation lower than an elevation, USGS Datum or other comparable source, to be determined on a case-by-case basis, said elevation being at least two (2) foot above the 100 year 24-hour storm event (maximum) assuming no outflow from the sinkhole. Minimum Floor Elevations for such lots are to be referenced and shown on the plat."

  2. Non-Residential Uses:

    1. "Identified sinkhole area(s) were investigated in the vicinity of ______________________. This investigation was performed by ____________________ (geotechnical engineer) on _____________ (date) and is on file with the offices of the Planning Commission and City Engineer, where applicable. The report details the activities used to explore these areas and any recommendations regarding non-buildable areas (shown on the plat/plan) and treatment areas suitable for construction."

    2. "Structures located adjacent to the closed contour of a sinkhole or adjacent to an immediate sinkhole drainage area shall not be permitted to have a basement or first floor elevation lower than an elevation, USGS Datum or other comparable source, to be determined on a case-by-case basis, said elevation being at least two (2) foot above the 100 year 24-hour storm event (maximum) assuming no outflow from the sinkhole. Minimum Floor Elevations for such lots are referenced and shown on the plat."

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