SAMPLE FORM FOR CORRECTIONS TO SUBDIVISION PLATS
| STATE OF (enter State of notary) | ) |
| ) ss AFFIDAVIT OF CORRECTION | |
| COUNTY OF(enter County of notary) | ) |
| I, (enter surveyor's name), P.L.S. No. (enter registration number), being duly sworn, depose and say that I am the surveyor who surveyed the plat of (enter subdivision name), as recorded in Book (enter book number), Page(s) (enter page number or numbers), Yamhill County Plat Records. | |
The following correction(s) to said plat (is/are) necessary and (is/are) as follows:
1.
2.
The present fee owner(s) of the property materially affected by this affidavit (is/are) as follows:
1.
2.
| (legible stamp & signature of surveyor) | (enter business address)________________ |
| Expiration date: | (enter business name)_________________ |
| (enter date), 200X | |
| NOTARY CERTIFICATE |
Signed and sworn to before me on (
enter date), 200X by (enter name of surveyor).(
enter signature of notary)____________________Notary Public for the State of (
enter State of notary)| My commission expires (enter expiration date). | (legible stamp of notary) |
| STATE OF OREGON | ) |
| ) ss | |
| COUNTY OF YAMHILL | ) |
| I, Dan E. Linscheid, Yamhill County Surveyor, do hereby certify that said Affidavit of Correction for (enter subdivision name) has been examined by me and that it complies with O.R.S. 92. | |
| Approved ___________________________, 200X. | |
| ________________________________________ | |
| Dan E. Linscheid, Yamhill County Surveyor | |