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 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 property boundary encroachments. It has not been
addressed by plat reviewing agencies. Owners are responsible for
resolving property boundary conflicts.