ATTACHMENT D: CERTIFICATES, ACKNOWLEDGEMENTS, AND APPROVALS
   Following, herewith, are representative certificates, acknowledgements, and approvals to be used on final plats, in accordance with Article V of these regulations. These certificates, acknowledgements, and approvals may be modified with the Commission's approval. Phrases shown in parentheses in these certificates shall be used if pertinent. All signatures must be written with black, waterproof, india ink. Provisions shall be made on each signature line for large signatures and date.
   Reference to Sections 5.0 (A)(17)(a), 5.0 (A)(17)(b), and 5.0(A)(17)(e)
   A.   DEDICATION CERTIFICATE:
      KNOW ALL MEN BY THESE PRESENTS: That I (we), the undersigned owner(s), mortgagee(s) or lienholder(s) being the only party (parties) with title interest in those lands described below, have laid out, subdivided and platted the same into lots, blocks, streets and public ways as shown here or under the name and style of                          , and do, by these presents, grant, dedicate and convey to the city of Dayton, state of Kentucky, for public use, all streets, public ways and drainage easements and one (1) foot strip designated as tract(s)                                   for non-road purposes (if applicable) to the city of Dayton, reserved to and for the use of all present and future owners of lots and tracts in this subdivision, easement over and across said lots and tracts as shown hereon, for the construction, maintenance and operation of utilities.
   LEGAL DESCRIPTION:
               SAID PARCEL CONTAINS         ACRES
In witness whereof                                                 as owner(s), has hereunto caused name to be signed and its corporate seal (if applicable) to be affixed by the undersigned officers, there unto duly authorized this      day of                 , 19       .
All individuals shall sign their names as shown on the Deed of Ownership, or as shown on Deeds of Trust, mortgages, liens, etc. Corporation ownership or interest shall be shown by the official signatures of the president and secretary. The full name of the corporation shall be shown above their signatures.
   ACKNOWLEDGEMENT:
   CITY OF                    )
   COUNTY OF                  ) s.s.
   STATE OF KENTUCKY       )
   Subscribed and sworn to before me this         day of           , 19      .
      By:                             
                                                      
                     NOTARY PUBLIC
   My Commission Expires:                                   
   Reference to Section 5.0(A)(17)(d) of these regulations
   B.   SURVEYOR'S CERTIFICATE:
      I, (Surveyor's name - printed) a Registered Land Surveyor in the State of Kentucky, do hereby certify that the survey of (subdivision name) was made by me (or under my supervision), and that the accompanying plat accurately and properly shows said subdivision and the survey thereof.
                      (Signature)
                  Registered Land Surveyor No.       
Reference to Section 5.0(A)(17)(c) of these regulations
   C.   TITLE COMPANY'S OR ATTORNEY'S CERTIFICATE:
      This title company (or attorney)                         licensed to practice in the State of Kentucky, do hereby certify that we (I) have examined the title to all lands described herein, as shown on said plat, and verify that the title of all such lands is in the owners name and is free and clear of all liens and encumbrances (and, if pertinent, "Except for deed of trust, mortgage, lien and etc. recorded in Book                 at Page          ,                       , City of                      , Records").
                                                         
               Signature of responsible official of
                     Title Company or Attorney
Reference to Section 5.0(A)(17)(g) of these regulations
   D.   APPROVAL CERTIFICATES:
      Approved by the Planning and Zoning Board of the city of Dayton, Campbell County, Kentucky this         day of                  A.D., 19          .
                                                                 Secretary                  Chairman
Reference to Section 5.0(A)(17)(g) of these regulationsE.   ACCEPTANCE CERTIFICATE
The city of Dayton, state of Kentucky, hereby accepts for maintenance, all improvements as defined in the construction agreement. The (city of Dayton -- or other applicable public body) hereby accepts, in fee simple, lands to be dedicated for public use as defined on the final plat (if applicable).
         CITY COUNCIL
         (or other appropriate public officer of the applicable
         agency accepting land).
                                                                  
   Clerk (if applicable)         Mayor (if applicable)
   Reference to Section 5.0(A)(17)(h) of these regulations
   F.   CLERK AND RECORDER'S CERTIFICATE
      Accepted for filing in the office of the County Clerk and Recorder of Campbell County at city of Dayton, county of Campbell, state of Kentucky, this                day of                      , A.D., 19            .
                     Reception No.                                                    Time                            County Clerk and Recorder
      Reference to Section 5.0(A)(17)(f) of these regulations
   G.   OTHER DOCUMENTS
      Such other affidavits, certificates, acknowledgements, endorsements, and notarial seals as are required by law by these regulations shall be of the form and substance approved by the Planning Commission.
(Ord. 1971-2, passed 4-6-71)