Form 1 TITLE Subdivision (name of) 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 and do hereby dedicate to public use the street(s) (easements) (parks or other public areas) designated in graphic symbols on this plat. ( (Witness) (owner) (signature) (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 by hand and official seal at (city) , (state) this day of (month), (year). Notary Public My Commission expires |
Form 3A ACKNOWLEDGMENT 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 is correct and accurate. 19 Registered Surveyor-Ohio Serial No. |
Form 5 APPROVAL BY PLANNING COMMISSION This plat of subdivision has been approved by the Planning Commission of the Municipality of , 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 $ , which has been posted with the to assure completion of all improvements in case of default. , 19 (date) Director of Engineering |
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 (date) Director of Engineering |
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 , Ohio, by Ordinance No. . , 19 President Clerk |
Form 8 ACCEPTANCE OF STREET AND UTILITIES FOR PUBLIC USE (Separate ordinance - not included on plat) The public street(s) accepted heretofore for dedication 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, , Ohio, by Ordinance No. . , 19 President Clerk |
Form 9 COUNTY RECORDS Transferred this day of , 19 . County Auditor Recorded in Plat Book , Page No. this day of , 19 . County Recorder |