C. - Minimum information required on the preliminary plat title sheet.

			YES	NO	N/A
1.	Title block
	a.	Subdivision name and address.	___	___	___
	b.	City of Martinsville tax map and parcel number.	___	___	___
	c.	Deed book reference and source of title.	___	___	___
	d.	Names and addresses of the owners of the property, the subdivider/developer, and the plat preparer.	___	___	___
	e.	Names and address of surveyor or engineer preparing the plat.	___	___	___
	f.	Scale of plat (1" = 100' or larger).	___	___	___
	g.	Date of plat preparation.	___	___	___
	h.	Project number (to be assigned by the city).	___	___	___
2.	Surveying and mapping control information.		___	___	___
3.	Vicinity map at a minimum scale of 1" = 1,000'.		___	___	___
4.	General information to include the number of plat sheets and an index showing the locations of the various sheets.		___	___	___
5.	Reference any proffers, special use permit conditions, waivers or variances granted. Copies of all are to be attached.		___	___	___
6.	Seal and signature (on each sheet) by a Virginia certified land surveyor or professional engineer.		___	___	___
7.	Owner's dedication and consent properly worded and notarized.		___	___	___
8.	Signature panel for city approval.		___	___	___
9.	Sheet size requirements (18" x 24" maximum).		___	___	___