Subdivision Plan/plat Application Form - Metropolitan Nashville - Planning Department Page 3
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7SURVEYOR
SURVEYOR
Surveyor’s
Name: __________________________________________
I have reviewed this application and the associated
SUBDIVISION SUBMITTAL CHECKLIST fully, and believe,
Address: ________________________________________
I have complied with all the requested submittal items.
I acknowledge that plans or documents missing any of the
City: _________________ State: ____ Zip: ____________
requested information may be deemed incomplete and not
accepted for project review. Further, I understand that
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□
Phone: __________________
business
home
cell
additional information or clarification may be requested during
the review process or prior to application approval. And for any
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□
□
Phone: __________________
business
home
cell
final plat where public improvements are required, I understand
that until I make all the requested plat revisions to the
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Fax:
__________________
business
home
satisfaction of the reviewing agencies, bond amounts cannot be
calculated, and thus, the plat cannot be recorded.
E-mail: __________________________________________
I also understand that the Metro Planning Dept. will send the
recorded plat to a printer to make 11 copies which are to be
folded and delivered by the printer to the Planning Dept. The
Surveyor
dept. will then distribute these copies to other agencies. The
_____________________________
:
Signature
printer will call me directly to come and pick-up the mylar. The
estimated cost for this service is $20 for a 1-page plat, and I
Print Name: _______________________________________
understand as the surveyor, I am fully responsible for paying
the printer.
_______________
Surveyor Initials
ENGINEER
(development plans only )
Engineer’s
ENGINEER
Name: __________________________________________
Address: ________________________________________
I have reviewed this application and the associated
SUBDIVISION SUBMITTAL CHECKLIST fully, and believe,
City: _________________ State: ____ Zip: ____________
I have complied with all the requested submittal items.
I acknowledge that plans or documents missing any of the
□
□
□
requested information may be deemed incomplete and not
Phone: __________________
business
home
cell
accepted for project review. Further, I understand that
□
□
□
additional information or clarification may be requested during
Phone: __________________
business
home
cell
the review process or prior to application approval.
□
□
Fax:
__________________
business
home
_______________
E-mail: __________________________________________
Engineer Initials
Engineer
“Subdivision Submittal Checklist” on-line at
_____________________________
:
Signature
Print Name: _______________________________________
Page 3 of 7
Rev. 7.0 (8/19/2010)
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