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Town of Monument 645 Beacon Lite Road Monument, CO 80132-0325 Ph: [PHONE REDACTED] FINAL PLAT CHECKLIST An application for a Final Plat shall be accompanied by the following information, unless one or more items are specifically waived in writing by the Planning Director: The Development Review Application form. The applicable Final Plat fee. Proof of legal ownership in the form of a current title policy. A project narrative or Letter of Interest, including a statement of the purpose of the application and a description of how the application meets the final plat review and approval criteria of Section 18.02.260 C of this title. A letter of representation, signed and notarized by the property owner(s), for any applicant that is not a property owner. A final plat document drafted in accordance with the Plat Specifications Checklist (attach). All final plats shall clearly and accurately set forth and include the information in the format prescribed in addition to any other information required to be shown on the final plat by the Planning Director. Any other reports and information deemed necessary by Town Staff at the pre-application meeting. Copies of the submittal materials in a format and quantity as specified by Town Staff. ---PAGE BREAK--- Town of Monument 645 Beacon Lite Road Monument, CO 80132-0325 Ph: [PHONE REDACTED] PLAT SPECIFICATIONS CHECKLIST All final plats shall be prepared in accordance with the following specifications: Plat size: twenty-four (24) inches by thirty-six (36) inches, with a one-half-inch margin on the top, bottom and right-hand side and a one-and-one-half-inch margin on the left-hand side. Sheets shall be numbered in sequence if more than one sheet is used. Title: The title shall include the type of subdivision (Final Plat or Plat Amendment) and the following addition information: Subdivision Name Prior Reception Numbers (Plat Amendments only) Legal Description Town of Monument, El Paso County, Colorado A blank 2¼" x 3" vertical box in the lower right-hand corner of the plat inside the margin, for use by the El Paso County Clerk and Recorder to place a recording stamp. Each sheet shall show the written and graphic scale, north arrow and date of survey preparation. A general vicinity map. Names and addresses of the applicant and surveyor. A statement by the surveyor of the basis of bearing for laying out the boundaries. A description of all monuments, both found and set, which mark the boundaries of the property, and a description of all control monuments used in conducting the survey. Signature and seal of the land surveyor. See Plat Certifications for signature block text and format. Signature blocks for owners, lien holders (if any) and Board of Trustees. See Plat Certifications for signature block text and format. Dedication and depiction of access rights-of-way to adjacent lands, if applicable. See Plat Certifications for signature block text and format. All recorded and apparent easements and right-of-ways on and/or adjacent to the property. A land and improvements survey and metes-and-bounds legal description of the property in question by a registered surveyor. All dimensions necessary to establish the boundaries in the field. All signatures in black, permanent ink. A final plat in a GIS shapefile format compatible with the County GIS database. ---PAGE BREAK--- 1 CERTIFICATE OF DEDICATION AND OWNERSHIP Know all men by these presents, that the undersigned, being all of the Owner(s), Mortgagee(s) and Lienholder(s) of certain lands in the Town of Monument, El Paso County, Colorado, described as follows: [If platted subdivision] Lot Block Subdivision Filing [If metes and bounds] Beginning (point of beginning) containing acres, more or less, have by these presents laid out, subdivided and platted the same into lots, tracts, and easements as shown on this plat, under the name and style of , and do hereby dedicate to the Town of Monument as public roads, the streets and roads as shown on said plat, these being . The undersigned hereby further dedicate all utility easements and dedicate to the Town (or the Tri-view Metropolitan District, Woodmoor Water and Sanitation District, as applicable) for public use all water and water rights, both tributary and non-tributary, arising upon, flowing upon or lying under the property as described and shown hereon. The undersigned hereby further dedicate to the public utilities the right to install, maintain and operate mains, transmission lines, service lines and appurtenances to provide such utility services within this subdivision or property contiguous thereto, under, along and across public roads as shown on this plat and also under, along and across utility easements as shown hereon. The lands comprising this subdivision are subject to certain covenants which are recorded in Book at Page of the records of El Paso County, Colorado. Executed this day of , 20 . Owner(s) Mortgagee(s) and Lienholder(s): STATE OF COLORADO ) ) SS COUNTY OF EL PASO ) SIGNED THIS DAY OF , 20 , COUNTY , STATE NOTARY SIGNATURE MY COMMISSION EXPIRES ---PAGE BREAK--- 2 SURVEYOR’S CERTIFICATE: I, , a Professional Land Surveyor in the State of Colorado, do hereby certify that the survey represented by this plat was made under my direct supervision and the monuments shown hereon actually exist and this plat accurately represents said survey. Professional Land Surveyor TITLE CERTIFICATE: I, an authorized representative of , a title insurance company licensed to do business in the State of Colorado, have made an examination of the public records and state that all owners, mortgagees, and lienholders of the property are listed in the certificate of ownership and dedication. Signed this day of , 20 . By: as of . State of Colorado ) ) ss. County of El Paso ) Signed this day of , 20 , County , State Notary signature My commission expires PLANNING DEPARTMENT REVIEW: This plat was reviewed by the Town of Monument Planning Department this day of , 20 . Planning Director STREET MAINTENANCE It is mutually understood and agreed by the subdivider and the Town of Monument that the dedicated public roads shown on this plat will not be maintained by the Town until and unless the subdivider constructs the streets and roads in accordance with the subdivision improvement agreement, if any, and the subdivision regulations and other Ordinances of the Town of Monument in effect at the date of the recording of this Plat, and approval of the Town has been issued to that effect. ---PAGE BREAK--- 3 TOWN APPROVAL: This plat is approved for filing and the Town hereby accepts the dedications shown hereon subject to the provisions in “Street Maintenance” set forth above, and further accepts the dedication of the easements shown hereon for the purposes stated. MAYOR DATE ATTEST: TOWN CLERK DATE RECORDERING STAMP - ---PAGE BREAK--- 4 SPECIAL WARRANTY DEED KNOW ALL MEN BY THESE PRESENTS, That , of the County of El Paso, and the State of Colorado whose address is , for the consideration of One dollar and other good and valuable consideration in hand paid, hereby sell and convey to THE TOWN OF MONUMENT, of the County of El Paso, and State of Colorado, whose address is 645 Beacon Lite Road, Monument, CO 80132, the following property situate in the County of El Paso and State of Colorado, to-wit: All water and water rights, including nontributary and not nontributary groundwater, appurtenant to and underlying the following described real property: (enter legal description of property and description of any existing decree for water rights). with all its appurtenances and warrant(s) the title against all persons claiming under us, and further warrant that said water rights are free and clear of all liens and encumbrances. Signed and delivered this day of , 20 . STATE OF COLORADO ) ) ss. COUNTY OF ) The foregoing instrument was acknowledged before me this day of , 20 , by . Witness my hand and official seal. My Commission Expires: ---PAGE BREAK--- 5 Notes: 1. Person signing for a corporation must be the President or a Vice President of the corporation and title must be stated with signature. 2. Notarization (acknowledgment) must also be completed. 3. Please attach any separate legal description. ---PAGE BREAK--- 6 STATE OF COLORADO OFFICE OF THE STATE ENGINEER DIVISION OF WATER RESOURCES NON-TRIBUTARY GROUND WATER CONSENT LANDOWNERSHIP STATEMENT I, (We) Name whose mailing address is Street City State Zip claim and say that I (we) am (are) the owner(s) of the following described property consisting of approximately acres in the County of El Paso, State of Colorado: (insert legal description) and that I (we) have granted written consent to Town of Monument to withdraw ground water from the * aquifer as evidenced by the attached copy of a deed or other document recorded in the County or Counties in which the land is located, and that said ground water has not been conveyed or reserved to another, nor has consent been given to withdrawal by another except as indicated in the attached deed or other recorded document. Further, I (we) claim and say that I (we) have read the statements made herein; know the contents hereof; and that the same are true to my (our) own knowledge. Signature Date Signature Date *Enter Dawson, Denver, Arapahoe or Laramie-Fox Hills – one form required for each aquifer.