APPENDIX I
Forms for Final Plat Certification
 
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)       (Witness)
      (lettered)         (                                
(owner) (signature)       
      (lettered)         (                                
 
 
Form 3    ACKNOWLEDGMENT 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    ACKNOWLEDGMENT BY CORPORATION
 
State of Ohio )
County of Cuyahoga)
   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 is correct and accurate.
 
                          19                                                               
Date              Registered Surveyor-Ohio Ser. #             
 
Form 5    APPROVAL BY PLANNING COMMISSION
 
   This plat of                    Subdivision has been approved for record purposes only by the Planning Commission of the Municipality of Pepper Pike, Ohio, by resolution adopted
                            , 19_____                                          
                  Chairman
                                                     
                  Secretary
 
 
Form 6    CERTIFICATE OF THE APPROVAL OF REQUIRED IMPROVEMENTS
 
I hereby certify that the pavements, 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 and performance guarantees in the amount of $                 have been posted with the                           to assure completion of all improvements in case of default.
 
               , 19                                                        
            Municipal Engineer
 
Form 6A    CERTIFICATE OF THE APPROVAL OF REQUIRED IMPROVEMENTS
   (not included on plat)
 
   I hereby certify that pavements, utilities and other required land improvements for the Subdivision approved by the Planning Commission on                      have been designed in accordance with the regulations and standards in effect, that I have inspected the installation of the same and find all improvements have been installed in accordance with the drawing and specifications therefor, and that the utilities and pavements are in good repair.
 
                          19                                                    
               Municipal Engineer
 
 
Form 7    ACCEPTANCE OF PUBLIC LANDS BY COUNCIL
 
   The public street(s) (park) (playground ) (easements) or (other public areas) as noted hereon in graphic symbols were accepted for dedication by the Council of the Municipality of Pepper Pike, Ohio, by ordinance No.                      .
 
                          19                                                    
               Clerk
 
 
Form 8    ACCEPTANCE OF STREET AND UTILITIES FOR PUBLIC USE
            (separate ordinance - not included on plat)
 
   The public street (s) and the public utilities has (have) been found to be constructed in accordance with the drawing, specifications, and design standards in effect and in good repair, is (are) hereby accepted for public use and maintenance by the Council of the municipality of Pepper Pike, Ohio, by Ordinance No.                      .
 
                          19                                                  
               Clerk
 
 
Form 9    COUNTY RECORDS
 
Transferred this                 day of                , 19      .
 
                                                   
               County Auditor
 
   Recorded in Plat Book                , Page No.               
   this                   day of                          , 19           .
                                                    
               County Recorder
 
(Ord. 1962-8. Passed 2-21-62.)