HUD-91073-OHF HUD Survey Instructions and Surveyor’s Report

HUD Survey Instructions and Surveyor’s Report Section 242

U.S. Department of Housing and Urban Development Office of Hospital Facilities

OMB Approval No. 2502-0602 (Exp. 08/31/2019)

Public reporting burden for this collection of information is estimated to average 8 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Reports Management Officer, QDAM, U.S. Department of Housing and Urban Development, Washington, DC 20410-5000. Do not send this completed form to the above address. Response to this request for information is required in order to receive the benefits to be derived. The information is being collected to obtain the supportive documentation which must be submitted to HUD for approval and is necessary to ensure that viable projects are developed and maintained. The Department will use this information to determine if properties meet HUD requirements with respect to development, operation and/or asset management, as well as ensuring the continued marketability of the properties. This agency may not collect this information, and you are not required to complete this form unless it displays a currently valid OMB control number. While no assurance of confidentiality is pledged to respondents, HUD generally discloses this data only in response to a Freedom of Information Act request.

This survey is to be used in a hospital loan transaction submitted to HUD.

Its uses will include:

[ ] Land title recordation (all cases)

[ ] Site grading plan preparation (item 1 below)

[ ] Plot plan design/redesign (item 2 below)

Special Project Features:

[ ] Condominium/Air rights, and/or

[ ] Other: (specify)_______________________

Standards of Performance: In every instance the survey and map(s) and/or plat(s) must be made in accordance with the requirements for an “ALTA/ACSM Land Title Survey” and in compliance with the:

• 2016 Minimum Standard Detail Requirements for ALTA/NSPS Land Title Surveys, jointly established and adapted by the American Land Title Association and the National Society of Professional Surveyors;

• Table A, Optional Survey Responsibilities and Specifications, thereof, items 1, 2, 3, 4, 6a, 6b, 7a, 8, 9, 10a, 10b, 11b, 12, 13, 16, 17, 18, and 19;

• And the following requirements as applicable:

1. Site Grading Involved: Comply with table A, item 5. Contours may not exceed 1-foot vertical intervals, except that 2-foot and 5­-foot vertical intervals may be used where the mean site gradient exceeds 5 percent and 10 percent respectively. Where curbs and/ or gutters exist, show top of curb and flow line elevations.

2. Plot Plan Design/Redesign Involved: Comply with Table A, Item 6.

3. Condominium/Air-rights Involved: The surveyor must provide a survey made in accordance with any Property Jurisdiction require­ments or, in the absence of such requirements, professionally recognized standards.

4. Flood Hazard Involved: Where any portion of the site is subject to flood hazard, show the 100-year return frequency flood hazard elevation and flood zone for all projects plus the 500-year return frequency flood hazard elevation and flood zone for Section 811 housing program. For existing projects show the site elevation at the building entrances, lowest habitable finished floor, and basement for each primary building, and the vehicular parking area that serves each primary building. Take return frequency flood hazard elevations from the applicable Federal Flood Insurance Rate Map. Where such is not available, take the elevations from available state or local equivalent data, or when not available, work in conjunction with owner's engineer.

5. Blanket Easement Involved. Show on the map/plat the location of any facility that is located within or traverses the property under provisions of a blanket easement.

Additional Owner Requirements: The following requirements are not intended to void any other part of this instruction.

Owner's Representative / Contact:

Name:

Address:

Phone No:

Certification: The survey map/plat must bear the ALTA/NSPS Certification:

“To (name of insured, if known), (name of lender, if known), (name of title insurer, if known), Department of Housing and Urban Development (“HUD”), (names of others as negotiated with the client):

This is to certify that this map or plat and the survey on which it is based were made in accordance with the 2016 Minimum Standard Detail Requirements for ALTA/ACSM Land Title Surveys, jointly established and adopted by ALTA and NSPS, and includes Items __________ of Table A thereof. The field work was completed on ___________[date].

Date of Plat or Map:_____ (Surveyor’s signature, printed name and seal with Registration/License Number)

Surveyor’s Report: A current Surveyor's Report (not more than 120 days old) must be included with the survey map(s)/plat(s) submitted to HUD for project design review, construction contract document sets, as required during construction, upon project completion; and with the map(s)/plat(s) used at initial and final closing. Identify pertinent observed and otherwise known conditions on the Surveyor's Report.

I certify that, on (date) ____________________________________________, I made a survey of the premises standing in the name of ______________________________________________________________________ situated in (city, county, state): ________________________________________________________________ known as street numbers _____________________________________________________________________ and shown on the accompanying survey entitled: __________________________________________________

I made a careful inspection of said premises and of the buildings located thereon at the time of making such survey, and again, on (date) ________________________, and on such latter inspection, I found said premises to be standing in the name of: ________________________________________________________________

In my professional opinion, the following information reflects the conditions observed on the date of the last site inspection or disclosed in the process of researching title to the premises, and I further certify that such conditions(s) are shown on the survey map/plat dated ________________ or has/have been updated thereon under Revision Date __________________.

(For Items 1 through 10, please provide a detailed answer or state “none,” if inapplicable.)

1. Rights of way, old highways or abandoned roads, lanes or driveways, drains, sewer or water pipes over and across said premises:

______________________________________________________________________________

______________________________________________________________________________

2. Springs, streams, rivers, ponds or lakes located, bordering on or running through said premises:

______________________________________________________________________________

______________________________________________________________________________

3. Cemeteries or family burying grounds located on said premises:

______________________________________________________________________________

______________________________________________________________________________

4. Electricity, or electromagnetic/communications signal, towers, antenna, lines, or line supports located on, overhanging or crossing said premises

______________________________________________________________________________

______________________________________________________________________________

5. Disputed boundaries or encroachments. (If the buildings, projections or cornices thereof or signs affixed thereto, fences or other indications of occupancy encroach upon adjoining properties or the like encroach upon surveyed premises, specify all such):

______________________________________________________________________________

______________________________________________________________________________

6. Earth moving work, building construction, or building additions within recent months:

______________________________________________________________________________

______________________________________________________________________________

7. Building or possession lines. (In case of city or town property specify definitely as to whether or not walls are independent walls or party walls and as to all easements of support or "Beam Rights." In case of country property report specifically how boundary lines are evidenced, that is, whether by fences or otherwise):

______________________________________________________________________________

______________________________________________________________________________

8. Recent street or sidewalk construction and/or any change in street lines either completed or proposed by and available from the controlling jurisdiction:

______________________________________________________________________________

______________________________________________________________________________

9. Flood hazard:

______________________________________________________________________________

______________________________________________________________________________

10. Site used as a solid waste dump, sump, or sanitary landfill:

______________________________________________________________________________

______________________________________________________________________________

Further, I hereby certify to HUD, (Borrower), (Sponsor), (Lender), (Title Insurance Underwriter), (Other), and to their successors and assigns, that:

I made an on the ground survey per record description of the land shown on the Survey No. __________________ , dated ____________ (“Survey”), located in (city or town, county, township, etc.), and that it was made in accordance with this HUD Survey Instructions and Surveyor’s Report, and the requirements for an ALTA/NSPS Land Title Survey, as defined in the 2016 Minimum Standard Detail Requirements for ALTA/NSPS Land Title Surveys.

To the best of my knowledge, belief and information, except as shown on the Survey: there are no encroachments across any property lines; title lines and lines of actual possession are the same; and the premises are [not subject to a] [subject to a] 100/500 year return frequency flood hazard, and such condition is shown on the Federal Flood Insurance Rate Map, Community Panel No. (please add “none,” if inapplicable).

WARNING: Federal law provides that anyone who knowingly or willfully submits (or causes to submit) a document containing any false, fictitious, misleading, or fraudulent statement/certification or entry may be criminally prosecuted and may incur civil administrative liability.  Penalties upon conviction can include a fine and imprisonment, as provided pursuant to applicable law, which includes, but is not limited to, 18 U.S.C. 1001, 1010, 1012; 13 U.S.C. 3729, 3802, 24 C.F.R. Parts 25, 28 and 30, and 2 C.F.R. Parts 180 and 2424.

Surveyor’s Name:	License Number:
Signature of Surveyor:	Date (mm/dd/yyyy)

Previous versions obsolete Page 5 of 5 form HUD-91073-OHF