The appropriate certificates stated below shall be inscribed with black waterproof India ink or varitype on the linen tracing, exactly as stated, and shall be properly signed with black waterproof India ink and attested when the plan is submitted for review or approval by the Allegheny County Planning Commission.
KNOW ALL MEN BY THESE PRESENTS, That (I or We) ____________________of the Municipality of Bethel Park, of the County of Allegheny, Commonwealth of Pennsylvania, for (myself, ourselves), (my, our) heirs, executors, administrators and assigns, do hereby adopt this plan as (my, our) Plan of Lots of (my, our) property, situate in Municipality of Bethel Park, Allegheny County, Pennsylvania, and for divers advantages accruing to (me, us), do hereby dedicate forever, for public use for highway purposes all slope areas and all drives, roads, streets, lanes, ways and other public highways shown upon the plan, with the same force and effect as if the same had been opened through legal proceedings, and in consideration of the approval of said plan, and any future acceptance of said public highways by the said Commonwealth of Pennsylvania, County of Allegheny and Municipality of Bethel Park, (I, we) hereby covenant and agree to and by these presents do release and forever discharge said Commonwealth of Pennsylvania, County of Allegheny and Municipality of Bethel Park, their successors or assigns from any liability for damages arising and to arise from any appropriation of said ground for public highways and the physical grading thereof to any grades that may be established hereafter at any time. This dedication and release shall be binding upon (Name of Owner), (my, our) heirs, executors, administrators and assigns and purchasers of lots in this plan.
IN WITNESS WHEREOF, (I, We) hereunto set (my, our) hand and seal this _____ day of ____________________, 19___.
Attest:
  Notary Public
  Owner
KNOW ALL MEN BY THESE PRESENTS; that the (Name of Corporation), a corporation incorporated under the laws of the Commonwealth of Pennsylvania, by virtue of a resolution of the Board of Directors, thereof, does hereby adopt this plan as its Plan of Lots of its property situate in Municipality of Bethel Park, Allegheny County, Pennsylvania, and for divers advantages accruing to it, does hereby dedicate forever, for public use for highway purposes, all slope areas and all drives, roads, streets, lanes and ways and other public highways shown upon the plan, with the same legal proceedings, and in consideration of the approval of said plan, and any future acceptance of said public highways by the said Commonwealth of Pennsylvania, County of Allegheny, and Municipality of Bethel Park, (Name of Corporation) hereby covenants and agrees to and by these presents does release and forever discharge said Commonwealth of Pennsylvania, County of Allegheny, and Municipality of Bethel Park, their successors or assigns from any liability for damages arising and to arise from the appropriation of said ground for public highways and the physical grading thereof to any grades that may be established hereafter at any time. This dedication and release shall be binding upon (Name of Corporation), its successors and assigns and purchasers of lots in this plan.
IN WITNESS WHEREOF, the said corporation has caused its corporate seal to be affixed by the hand of its President and same to be attested by its secretary this _____ day of ____________________, 19___.
Attest:
Name of Corporation
  Secretary
(Seal)
  President
COMMONWEALTH OF PENNSYLVANIA
)
ss:
COUNTY OF ALLEGHENY
)
Before me, the subscriber, a Notary Public in and for said Commonwealth and County, personally appeared the above named (Name of Owner), and acknowledged the foregoing release and dedication and plan to be (his, her, their) act and deed and desired the same to be recorded as such.
Sworn to and subscribed before me this day.
WITNESS MY HAND AND NOTARIAL SEAL THIS _____ day of ____________________, 19___.
My Commission Expires the _____ day of ____________________, 19___.
(Seal)
  Notary Public
 
COMMONWEALTH OF PENNSYLVANIA
)
ss:
COUNTY OF ALLEGHENY
)
Before me, the subscriber, a Notary Public in and for said Commonwealth and County, personally appeared (Name and Title of Officer) of the (Name of Corporation) who being duly sworn, deposeth and saith that he was personally present at the execution of the adoption, release and dedication and saw the common and corporate seal of the said corporation duly affixed and that the above release and dedication was duly signed and sealed by and as for the act and deed of the said (Name of Corporation), for the uses and purposes therein mentioned and that the name of this deponent subscribed to the said release and dedication as (Title of Officer) of said corporation. In attestation of the due execution and delivery of said release and dedication is this deponent's own and proper and respective handwriting.
Title of Officer
Sworn to and subscribed before me this day.
WITNESS MY HAND AND NOTARIAL SEAL THIS _____ day of ____________________, 19___.
My Commission Expires the _____ day of ____________________, 19___.
(Seal)
  Notary Public
I, (or We) (Name of Owner) owners of the title of this property is in the name of as recorded in Deed Book Volume page, Recorder of Deeds Office. I (or We) further certify that there is no mortgage, lien or encumbrance against this property.
  Witness
  Owner
I, (or We) (Name of Mortgagee) mortgages of the property embraced in this plan of subdivision, vision, (Name of Plan), do hereby consent to the recording of said plan in the Recorder's Officer's of Allegheny County, Pennsylvania and to the dedications and covenants appearing hereon.
  Witness
  Mortgagee
I (or We) (Name of Mortgagee) mortgagee of the property embraced in this (Name of Plan), do hereby consent to the recording of said plan in the Recorder of Deeds Office of Allegheny County, Pennsylvania, and to the dedications and covenants appearing hereon.
  Witness
  Mortgagee
KNOW ALL MEN BY THESE PRESENTS, THAT (I or We) Name of owner/developer) of the (City, Borough, Municipality) of PA, of the County of Allegheny, Commonwealth of Pennsylvania, for (myself, ourselves), (my, our) heirs, executors, administrators and assigns, do hereby adopt this plan as (my, our) (Plan of Lots, Land Development) of (my, our) property, situated in (City, Borough, Township, Municipality), Allegheny County, Pennsylvania, and for divers advantages accruing to (me, us), do hereby dedicate forever, for public use for highway purposes all slope areas and all drives, roads, streets, lanes, ways and other public highways shown upon the plan, with the same force and effect as if the same had been through legal proceedings, and in consideration of the approval of said plan, any future acceptance of said public highways by the Commonwealth of Pennsylvania, County of Allegheny, and (City, Borough, Township, Municipality) of PA, (I, We) hereby covenant and agree to and by these presents do release and forever discharge said Commonwealth of Pennsylvania, County of Allegheny and (City, Borough, Township, Municipality) of ____________________, their successors or assigns from any liability for damages arising and to arise from any appropriation of said ground for public highways and the physical grading thereof to any grades that may be established. This dedication and release shall be binding upon (Name) (My, Our) heirs, executors, administrators and assigns and purchasers of (Lots, Units) in this plan.
(I or We) (Owner/Developer) also hereby agree to record a survey of final construction of each lot with the Office of the Recorder of Deeds of Allegheny County prior to any conveyance of any part thereof.
IN WITNESS WHEREOF, (I, We) hereunto set (My, Our) hand and seal this _____ day of ____________________, 19___.
ATTEST:
Notary Public
Owner/Developer
I, ____________________, a Registered Surveyor of the Commonwealth of Pennsylvania, do hereby certify that this plan correctly represents the lots, lands, streets and highways as surveyed and plotted by me for the owners or agents.
(Seal)
(Signature of Surveyor)
  Date
Registration Number
The Municipal Council of the Municipality of Bethel Park hereby gives public notice that in approving this plan for recording purposes only, the Municipality of Bethel Park assumes no obligations, legal or otherwise, expressed or implied either to accept said streets as Municipal streets or roads or grade, pave and curb the streets in said plan, or to construct sewers therein or to install any other such service ordinarily installed in Municipal streets or roads.
(Seal)
  Secretary
  President
Approved by the Municipal Council of the Municipality of Bethel Park by Resolution, this _____ day of ____________________, 19___.
(Seal)
  Secretary
  President of Council
Reviewed by the Municipal Planning Commission this _____ day of ____________________, 19___.
(Seal)
  Secretary
  Chairman
Reviewed by the Allegheny County Planning Commission this _____ day of ____________________, 19___.
  Director
COMMONWEALTH OF PENNSYLVANIA
)
ss:
COUNTY OF ALLEGHENY
)
Recorded in the Recorder's Office for the recording of deeds, plans, etc., in said County in Plan Book Volume _____ Page _____.
Given under my hand and seal this _____ day of ____________________, 19___.
(Seal)
  Recorder
I, ____________________, a Registered Professional Engineer for the Municipality of Bethel Park do hereby certify that this subdivision plan meets all the engineering and design requirements of the Municipality of Bethel Park Subdivision and Zoning Ordinances.
  Date
  Reg. No.
(Seal)
  Signature
Approval of this Subdivision, or execution of this Linen, is no guarantee by the Municipality of Bethel Park that any or all sewer connections or taps necessary for completion of this entire plan will be approved or issued.
The Municipality of Bethel Park of Allegheny County, Pennsylvania agrees not to issue Building Permits or to permit development on any portion of this plan until such time as sewage disposal planning is completed in accordance with the provisions of the rules and regulations of the Pennsylvania Department of Environmental Resources.
Note: A Pennsylvania Dept. of Transportation Highway Occupancy Permit is required pursuant to Section 420 of the "State Highway Law" before driveway access to a state highway is permitted
An easement for (drainage) (slope) (sanitary sewer) purposes and for the installation, repair and replacement of utilities over the easement parcels located in the Municipality of Bethel Park, County of Allegheny and Commonwealth of Pennsylvania and designated as" "on the subdivision plan.
TO HAVE AND TO HOLD, the said easements for drainage and/or slopes and for the installation, repair and replacement of utilities and associated purposes and for no other use or purpose whatsoever.
And the said Owners, for themselves, their successors and assigns, by these presents covenant, promise and agree to and with the Municipality of Bethel Park, its successors and assigns, that neither the Owners nor their successors or assigns, shall nor will at any time hereafter, ask, demand, recover or receive of or from the said Municipality, its successors and assigns any sum or sums of money as and for damages for or by reason of the implementation of the easements herein conveyed except for any cost for replacement of existing improvements damage by utilization of the easement.