Each plat of a subdivision submitted to the 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 do hereby lay off, plat and subdivide, said real estate in accordance with the within plat.
This subdivision shall be known and designated as (name) , a subdivision of or an addition to                     , Indiana. All streets and alleys shown and not heretofore dedicated are hereby dedicated to the public.
Front and side 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.
There are strips of ground (number) feet in width as shown on this plat and marked “Easement,” reserved for the use of public utilities for the installation of water and sewer mains, poles, ducts, lines and wires, subject at all times to the proper authorities and to the easement herein reserved.
No permanent or other structures are to be erected or maintained upon said strips of land, but owners of lots in this subdivision shall take their titles subject to the rights of the public utilities.
(Additional dedications and protective covenants, or private restrictions, would be inserted here upon the subdivider’s initiating 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, 20        , (a 25-year period is suggested), at which time said covenants (or restrictions) shall be automatically extended for successive periods of ten 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.
Witness our hands and seals this                  day of                          , 20              .
State of Indiana   )
County of Ripley   )
Before me, the undersigned Notary Public, in and for said County and State personally appeared (names) 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                       , 20            .
                                                                           (Notary Public)
County of Residence:                                                   
My Commission Expires:                                              
(Ord. passed 6-5-1991)