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Commonwealth of Pennsylvania:
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SS.
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County of
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On the _____ day of ____________________, 19_____,
before me the subscriber, a Notary Public of the Commonwealth of Pennsylvania,
residing in ____________________, ____________________ personally
appeared (name or names of all owners), known to me (or satisfactorily
proven) to be the persons whose names (is/are) subscribed to the foregoing
plan, and acknowledge that (he/she/they) (is/are) the registered (owner/owners)
of the designated plan, that all necessary approval of the plan has
been obtained and is endorsed thereon, and that (he/she/they) desire
that the foregoing plan be recorded according to law.
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Witness my hand and notarial seal, the day and
year aforesaid.
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Notary Public
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My Commission Expires
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(SEAL)
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Commonwealth of Pennsylvania:
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SS.
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County of
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On the _____ day of ____________________, 19_____,
before me the subscriber, a Notary Public of the Commonwealth of Pennsylvania,
residing in ____________________, ____________________ personally
appeared (name of officer of corporation), who acknowledged (himself/herself)
to be the (president/ secretary) of (name of the corporation), a corporation,
and that as such (president or secretary), being authorized to do
so, (he/she) executed the foregoing plan by signing that the said
corporation is the registered owner of the designated land, that all
necessary approval of the plan has been obtained and is endorsed thereon,
and that (he/she/they) desire that the foregoing plan be recorded
according to law.
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Witness may hand and notarial seal, the day
and year aforesaid.
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Notary Public
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My Commission Expires
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(SEAL)
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Board of Supervisors:
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Approved by the Board of Supervisors of the
Township of Doylestown this _____ day of ____________________, 19_____.
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Township Engineer:
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Recorded in the office of the Recorder of Deeds,
Bucks County, Pennsylvania, in Plan Book _______ Page _____ on the
____ day of ____________________, 19_____.
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Bucks County Planning Commission Notation
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BCPC No.
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PROCESSED AND REVIEWED. Report prepared by the
Bucks County Planning Commission in accordance with the Municipalities
Planning Code. Certified this date
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Executive Director, Bucks County Planning Commission
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