(1) A declaration of short subdivision;

(2) The written approval of the public works director and the planning director shall be inscribed on the face of the final short plat;

(3) The inscription of the surveyor, certifying that the map correctly represents a survey made by or under his or her supervision;

(4) If the short plat contains a private road, there shall also be inscribed on the face of the short plat the following language:

Notice: The city of Stanwood has no responsibility to build, improve, maintain or otherwise service the private roads within or providing access to the property described in this short plat.