Each record plat submitted to the City Plan Commission for approval shall carry a deed of dedication in substantially the following form.
"We the undersigned     (Names)    , owners of the real estate shown and described herein, do hereby certify that we have laid off, platted and subdivided, and hereby lay off, plat and subdivide, said real estate in accordance with the within plat.  We do further certify that this plat is made and submitted with our free consent and desires.
This subdivision shall be known and designated as     (Name)      , an addition to       (Name)        .  All streets and alleys shown and not heretofore dedicated, are hereby dedicated to the public.
Front yard building setback lines are hereby established as shown on this plat, between which lines and the property lines of the street, there shall be erected or maintained no building or structure.
A perpetual easement is hereby granted to any local public utility or municipal department, their successors and assigns, within the area shown on the plat and marked "Easement," to install, lay, construct, renew, operate, maintain and remove conduits, cables, pipes, poles and wires, overhead and underground, with all necessary braces, guys, anchors and other equipment for the purpose of serving the subdivision and other property with telephone, electric and gas, sewer and water service as a part of the respective utility systems; also is granted (subject to the prior rights of the public therein) the right to use the streets and lots with aerial service wires to serve adjacent lots and street lights, the right to cut down and remove or trim and keep trimmed any trees or shrubs that interfere or threaten to interfere with any of the said public utility equipment, and the right is hereby granted to enter upon the lots at all times for all of the purposes aforesaid.  No permanent buildings or trees shall be placed on said area as shown on the plat and marked "Easement," but same may be used for gardens, shrubs, landscaping and other purposes that do not then or later interfere with the aforesaid user or the rights herein granted.
(Additional dedications and protective covenants, or private restrictions would be inserted here upon the subdivider's initiative or the recommendations of the Commission; important provisions are those specifying the use to be made of the property and, in the case of residential use, the minimum habitable floor area.)
The foregoing covenants, (or restrictions), are to run with the land and shall be binding on all parties and all persons claiming under them until January 1, 19  , (a twenty-five (25)-year period is suggested), at which time said covenants, (or restrictions), shall be automatically extended for successive periods of ten (10) years unless changed by vote of a majority of the then owners of the building sites covered by these covenants, or restrictions, in whole or in part. Invalidation of any one of the foregoing covenants, or restrictions, by judgment or court order shall in no way affect any of the other covenants or restrictions, which shall remain in full force and effect.
The right to enforce these provisions by injunction, together with the right to cause the removal, by due process of law, of any structure or part thereof erected, or maintained in violation hereof, is hereby dedicated to the public, and reserved to the several owners of the several lots in this subdivision and to their heirs and assigns."
Witness our Hands and Seals this       day of               , 19  .
State of Indiana    )
              )  SS:
County of Clinton )
Before me the undersigned Notary Public, in and for the County and State, personally appeared     (Name)    ,     (Name)    ,     (Name)    , and each separately and severally acknowledge the execution of the foregoing instrument as his or her voluntary act and deed, for the purposes therein expressed.
Witness my hand and notarial seal this     day of           , 19  .
My Commission Expires:
(Ord. CO-67-5, passed 2-21-67)