Form 1 TITLE
(name) Subdivision
Part of original tract
(municipality)
(county)
Form 2 CERTIFICATE OF OWNERSHIP AND DEDICATION
I (we), the undersigned (name lettered) owner(s) of the property shown and described hereon as the Subdivision, do hereby assent to and adopt this subdivision of the same, and acknowledge that the same was made at our request.
(owner) (signature) (
(lettered) (Witness)
(
(owner) (signature) (
(lettered)
Form 3 ACKNOWLEDGEMENT BY INDIVIDUAL (directly below the above certificate)
State of Ohio )
County of )
Before me, a Notary Public in and for said County and State, personally appeared the above who
acknowledged that he (she or they) did sign the foregoing instrument and that the same is his (her or their) free act and deed.
IN WITNESS WHEREOF, I have hereunto set my hand and official seal at , Ohio, this day of , 19 .
Notary Public
My Commission Expires
Form 3A ACKNOWLEDGEMENT BY CORPORATION
State of Ohio )
County of )
Before me, a Notary Public in and for said County and State, personally appeared , President, and , Secretary, of , the corporation which executed the foregoing instrument, who acknowledged that they did sign said instrument as such president and secretary in behalf of said corporation and by authority of its board of directors, and that said instrument is their free act and deed, individually and as such officers, and the free and corporate act and deed of said corporation.
IN WITNESS WHEREOF, I have hereunto set my hand and official seal at , Ohio, this day of , 19 .
Notary Public
My Commission Expires
Form 4 CERTIFICATE OF SURVEYOR
I hereby certify that I have prepared this survey and plat of Subdivision and that the same are correct and accurate.
Registered Surveyor - Ohio Ser. #
Date 19
Form 5 APPROVAL BY COUNCIL
This plat of Subdivision has been approved for record purposes only by the Council of the Village of Gates Mills, Ohio, by resolution No. adopted .
, 19
Clerk of Council
Form 6 CERTIFICATE OF THE APPROVAL OF BOND FOR REQUIRED IMPROVEMENTS
I hereby certify that the streets, utilities and other required improvements for the subdivision herein approved have been designed in accordance with the regulations and standards in effect, that I have estimated the cost of materials and construction to be $ and that performance guarantees in the amount of $ have been posted to assure
completion of all improvements in case of default.
, 19
Village Engineer
Form 6A CERTIFICATE OF THE APPROVAL OF CONSTRUCTION OF REQUIRED IMPROVEMENTS
I hereby certify that the streets, utilities and other required land improvements for the Subdivision, approved by the Planning and Zoning Commission on , have been designed in accordance with the regulations and standards in effect, that I have inspected the installation of the same and have found that all improvements have been installed in accordance with the drawing and specifications therefor, and that those improvements are in good repair.
, 19
Village Engineer
Form 7 ACCEPTANCE OF PUBLIC LANDS BY COUNCIL
The (park) (playground) (easements) or (other public areas), as noted hereon in graphic symbols, were accepted for dedication by the Council of the Village of Gates Mills, Ohio, by Ordinance No. .
, 19
Clerk
Form 8 ACCEPTANCE OF STREETS FOR PUBLIC USE
The public street(s) has (have) been found to be constructed in accordance with the drawing, specifications and design standards in effect and in good repair, and is (are) hereby accepted for public use and maintenance by the Council of the Village of Gates Mills, Ohio, by Ordinance No. .
, 19
Clerk
Form 9 NOTATION THAT STREETS NOT ACCEPTED FOR PUBLIC USE
"Plat approved by the Council of the City of for the purpose of record on this day of by Ordinance No. . The approval of this plat does not constitute an acceptance as public thoroughfares of the streets shown thereon nor does such approval constitute an acceptance of such streets by the Village of Gates Mills for the purpose of maintenance thereof".
,19
Clerk
Form 10 COUNTY RECORDS
Transferred this day of , 19 .
County Auditor
Recorded in Plat Book , Page No. .
this day of , 19
County Recorder