City of Knoxville Engineering Department
The Knoxville Engineering Department hereby approves this plat on this the___________day of ________________________, 20___

____________________________________
Engineering Director

Guarantee of Completion of Drainage Systems
I, the undersigned, hereby certify bond or other security has been posted with the appropriate agency to insure completion and stabilization of all drainage systems as shown on drainage plans which were approved the ______day of __________, 20____, within a period not to exceed one year from date of approval.

Signed:_______________________________ Date:___________________

Dept:_________________________________ Title:___________________

Guarantee of Completion of Streets and Related Improvements
I, the undersigned, hereby certify bond or other security has been posted with the appropriate agency to insure completion of all streets and related improvements including indicated permanent reference monuments, benchmarks and iron pins in this subdivision in accordance with required standards and specifications with a period not to exceed one year from date of approval of the Final Plat.

Signed:_______________________________ Date:___________________

Dept:_________________________________ Title:___________________

Special Pollution Abatement Permit
I, the undersigned, hereby certify that the stormwater quality facilities shown
on this plat have been approved by Special Pollution Abatement Permit
No. __________, approved by the City of Knoxville's Department of
Engineering on the _______ day of _______________________, 20____.

Signed:_______________________________ Date:___________________

Dept:_________________________________ Title:___________________

City – 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 map, on the condition that new utility and drainage easements are provided along the new property lines.
City of Knoxville Engineering Department
Signed:____________________ Date:___________________

Knoxville Utilities Board (Water & Wastewater)
Signed:____________________ Date:____________________

Knoxville Utilities Board (Gas)
Signed:____________________ Date:____________________

Knoxville Utilities Board (Electric)
Signed:____________________ Date:____________________

BellSouth
Signed:____________________ Date:____________________

Cable Television
Signed:____________________ Date:____________________

No easements to release: RLS certification
This is to certify that there are not recorded drainage easements or utility easements on lot line(s) being eliminated on this Subdivision plat.

Date: ___________ Signature: ______________________________

Owner’s Responsibility Note
The property owner(s) is (are) responsible for maintaining stormwater facilities on this property. See Covenants document recorded with the Register of Deeds as Instrument No. _________________________.

Subdivision and Transfer of Property Only Note
This plat is approved for the subdivision and transfer of property only. Another plat may be required if new stormwater quantity and/or water quality facilities are needed for future development.

Property Boundary Encroachment Note
This survey indicates one or more property boundary encroachments. It has not been addressed by plat reviewing agencies. Owners are responsible for resolving property boundary conflicts.

Grid North Statement
GRID NORTH is based on a bearing of X Degº Min' Sec" Y from City Control Point #_____ to #_____. Distances have not been reduced to grid.

Example:
GRID NORTH is based on a bearing of N 59º 07' 35" E from City Control Point # 0317 to # 0309. Distances have not been reduced to grid.