APPENDIX D: ACCEPTANCE OF DEDICATIONS

By the power granted to me by the Fortville Town Council at their meeting on the 5th day of June, 2017, the public right-of-way and public infrastructure is hereby approved and accepted for                          on this        day of                       , 20      .

Joe Renner

Fortville Town Manager

STATE OF INDIANA   )

            ) SS:

COUNTY OF HANCOCK   )

Before me, a Notary Public in and for said County and State, personally appeared Joe Renner, by me known to be the Fortville Town Manager who acknowledged the Acceptance of Dedication of the public right-of-way and public infrastructure for                                                        .

      WITNESS my hand and Notarial Seal this       day of                          , 20     .

                                                                My Commission Expires:                                  

Notary Public

                                                                My County of Residence:                                  

Printed Name

(Ord. 2020-1D, passed 1-6-20)