APPENDIX A: STATEMENTS AND ACKNOWLEDGMENTS
RECOMMENDED STATEMENTS AND ACKNOWLEDGMENTS TO APPEAR ON THE PRELIMINARY PLAN OR THE FINAL PLAN AS APPLICABLE
1.   Certificate by surveyor that the survey and plans are correct:
I, _____________________________________ hereby certify that I am a registered Land Surveyor in the Commonwealth of Pennsylvania. I further certify that this plat correctly represents a survey completed by me and that all monuments and markers shown hereon actually exist and that their location, type and material are accurately shown.
   DATE _______________________________   SIGNATURE ________________________
         Seal
   A seal which includes the name of the surveyor (for major subdivisions)
2.   Certificate for Erie County Metropolitan Planning Department:
Reviewed by the Erie County Metropolitan Planning Department on _______________, ___, 20___.
   Director ______________________________   Reviewed by _________________________
3.   Certification of Ownership and Acknowledgement of Subdivision Plans:
On this, the ______day of _______________, 20___ before me, the undersigned officer, personally appeared _______________________________, who being duly sworn according to law, deposes and says that he or she is the owner and/or equitable owner of the property shown on this plan, and that he or she acknowledges the same to be his or her act and plan and desires the same to be recorded as such according to law.
   Witness my name and seal the day and date above written.
   _____________________________________
   Notary Public or other officer
   _____________________________________   ____________________________________
   Seal                               My Commission Expires
4.   Certificates for Municipality and its Planning Commission:
Approved by resolution of the Council of the City of Corry this ____ day of _______________, 20___.
   ATTEST:
   ________________________________   ______________________________________
   City Clerk                         Mayor
Approved by the Planning Commission of the City of Corry this _____ day of ________________, 20___.
                                                                                    
                                                                                    
                                                                                    
RECOMMENDED STATEMENTS AND ACKNOWLEDGEMENTS WHICH WILL BE SEPARATE INSTRUMENTS REFERENCED TO THE FINAL PLAN
5.   Certificate of Dedication:
We, the undersigned owners of the real estate shown and described herein, do hereby certify that we have laid off, platted and subdivided, and hereby lay off, plan and subdivide, said real estate in accordance with the within plat, that the subdivision shall be known and designated as __________________________________________ (Name of Subdivision) and that all streets and alleys shown and not heretofore dedicated, are hereby dedicated to public use.
   Date: _____________________________   _____________________________________
                                 _____________________________________
                                 _____________________________________