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PLATTING WORKSHEET DALLAS COUNTY, IOWA THIS SPACE FOR RECORDER'S USE ONLY SLIDE # SUBDIVISION NAME: LEGAL DESCRIPTION: CONTACT NAME ADDRESS CITY/STATE/ZIP PHONE NUMBER Documents Required – Iowa Code Section 354 1. County Auditor – statement approving the name of a subdivision – HF 2177 (effective date 7/1/2006) 2. FINAL PLAT – Four drawings (FULL SIZE) (Five if rural) plus one original no greater than 11" X 17" or no less than 8 1/2" X 11" in size Must have one original drawing with original signature 3. ACCEPTANCE by City, County or both depending on location. The stamp and signature of the Planning & Zoning Administrator must be affixed to surveyor's drawings for rural subdivisions. If within two miles of a city, check if city consent is required. 4. SURVEYOR'S CERTIFICATION – An original signature by a registered land surveyor, surveyor's registration number and legible seal affixed to final drawings. 5. DEDICATION OF OWNER – Statement signed by all parties consenting to the property being subdivided. In addition, if any property within these boundaries has been sold, the consent of the titleholders or contract purchasers will be needed. 6. RESTRICTIVE COVENANTS – if applicable 7. ACCEPTANCE OF MORTGAGE HOLDER(S) – if applicable 8. TREASURER'S CERTIFICATE – To include subdivision name, legal description & current ownership. Document certifies the property is free of encumbrances & taxes are paid unless so stated. This document is prepared by the party initiating the subdivision and is submitted to the County Treasurer along with a copy of the attorney's opinion for review & signature. 9. ATTORNEY'S OPINION – Document stating that the property is free of liens and encumbrances or listing applicable liens and encumbrances. Also denoting who is the owner of the platted land. CONTACT PERSON SIGNATURE TYPED OR PRINTED CLARIFICATION OF ABOVE