APPENDIX A
CERTIFICATIONS AND APPROVALS
CERTIFICATIONS AND APPROVALS
(a) Subdivision Plat Required Statement.
The undersigned hereby certify that the attached plat correctly represents their " ", a subdivision of lots to inclusive, do hereby accept this plat of same and dedicate to public use as such all of the streets, roads, boulevards, cul-de-sacs, parks, planting strips, etc., shown herein and not heretofore dedicated.
The dimensions of the lots and streets are shown on the plat in feet and decimal parts thereof. Easements are reserved where indicated on the plat for public utility purposes above and beneath the surface of the ground.
In Witness thereof have hereunto set their hands this day of , 19 .
Witness: Signed:______________________________
_________________________ ______________________________
We do hereby certify that we have surveyed the premises and prepared the attached plat and that said plat is correct; that all required survey monuments are correctly shown thereon; that those which are necessary for construction of improvements are in place on the site and that any remaining survey monuments will be properly placed upon completion of construction.
Dimensions on curves are chord measurements.
By: __________________________
Registered Surveyor
STATE OF OHIO )
) SS
COUNTY OF RICHLAND: )
Before me a Notary Public in and for said County personally came who acknowledge the signing of the foregoing instrument to be their voluntary act and deed for the uses and purposes therein expressed.
In witness whereof I have hereunto set my hand and affixed my official seal this ___ day of , 19 .
_____________________________
Notary Public
(b) Approvals.
(1) Within the Three Mile Limit of a City.
Approved this day of , 19 .
Secretary, City Planning Commission
Mansfield, Ohio
Approved this day of , 19 .
City Engineer
Approved this day of , 19 .
Richland County Engineer
Approved this day of , 19 .
Richland County Sanitary Engineer
Approved this day of , 19 .
Richland County District Board of Health
Approved this day of , 19 .
Director, Richland County Regional
Planning Commission
Approved and accepted this day of , 19____, and the roads, boulevards, etc., herein dedicated to public use are hereby accepted as such for the County of Richland, State of Ohio.
Richland County Commissioners
Transferred this day of , 19 .
Richland County Auditor
Filed for record this day of , 19 at M. Recorded this day of , 19 in Plat Book , Page Number .
_______________________________
Richland County Recorder Deputy Recorder
(2) Within a City.
Approved this day of , 19 .
Secretary, City Planning Commission
Approved this day of , 19 .
City Engineer
Approved this day of , 19 .
City Board of Health
Notes: 1. If the proposed subdivision is partially inside a City or Village it must also be signed by the City Clerk or Village Clerk.
2. If public sewer and water are available, the plat need not be signed by the Richland County District Board or City Board of Health.
(Ord. 64-222. Passed 9-15-64.)