[Ord. 215, 3/8/1976, § 1101]
The applicable certificates stated below shall be inscribed with black waterproof India ink or veritype on the linen tracing, exactly as stated, and shall be properly signed with black waterproof India ink. The statements in parentheses are optional in most cases.
[Ord. 215, 3/8/1976, § 1102]
KNOW ALL MEN BY THESE PRESENTS, this (I or we) (Name of Individual Owner) of the (Borough or Township) of __________, of the County of __________, 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 Harmar Township, 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 streets and ways shown upon the plan, with the same force and effect as if the same had been opened through legal proceedings (and do hereby dedicate forever, for public use the designated land areas on the plan for recreation and other purposes) 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 Township of Harmar, (I, we) hereby covenant and agree to and by these presents do release and forever discharge said Commonwealth of Pennsylvania, County of Allegheny and Township of Harmar, 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 __________, 20 _____.
ATTEST:
 Notary Public
 Owner
[Ord. 215, 3/8/1976, § 1103]
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 Harmar Township, 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 streets and ways shown upon the plan, with the same force and effect as if the same had been opened through legal proceedings, (and does hereby dedicate forever for public use the designated land areas on the plan for recreation and other purposes) 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 Township of Harmar, (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 Harmar Township, 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 hand of its President and same to be attested by its secretary this _____ day of __________, 20_____.
ATTEST:
(Name of Corporation)
(SEAL)
 Secretary
 President
[Ord. 215, 3/8/1976, § 1104]
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 of __________, 20 _____.
My commission expires the _____ day of __________, 20 _____.
SEAL
 Notary Public
[Ord. 215, 3/8/1976, § 1105]
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 and subscribed to before me this day.
WITNESS MY HAND AND NOTARIAL SEAL this _____ day of __________, 20 _____. My commission expires the _____ day of __________, 20_____.
(SEAL)
 Notary Public
[Ord. 215, 3/8/1976, § 1106]
I, (or We) (Name of Owner), owners of the (Name of Plan), do hereby certify that 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
[Ord. 215, 3/8/1976, § 1107]
If the property embraced in this plan is encumbered by a mortgage, judgment of record, or otherwise, the following certificates shall appear.
I, (or We) (Name of Owner) owners of the (Name of Plan) do hereby certify that the title of this property is in the name of __________, as recorded in Deed Book Volume _____, Page _____, Recorder of Deeds Office.
 Witness
 Owner
I, (or We) (Name of Mortgagee) mortgagee of the property embraced in this plan or subdivision, (Name of Plan), do hereby consent to the recording of said plan in the Recorders Office of Allegheny County, Pennsylvania and to the dedications and covenants appearing hereon.
 Witness
 Owner
[Ord. 215, 3/8/1976, § 1108]
I __________, a Registered Professional Engineer (or Registered Surveyor) of the Commonwealth of Pennsylvania, do hereby certify that the plan as shown hereon is based upon actual field survey of the land described and that all angles, distances and courses are correctly shown, that the monuments and markers have been set as shown on the plat, and that this plan correctly represents the lots, land, streets and highways as surveyed and plotted by me for the owners or agents.
(SEAL)
 Date
Signature of Engineer
Registration Number
[Ord. 215, 3/8/1976, § 1109]
The Board of Supervisors of the Township of Harmar hereby gives public notice that in approving this plan for recording purposes only, the Township of Harmar assumes no obligations, legal or otherwise, expressed or implied either to accept said streets as Township 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 Township streets or roads.
(SEAL)
 Secretary
 Chairman, Board of Supervisors
[Ord. 215, 3/8/1976, § 1110]
It is hereby certified that all lots in the subdivision (or all dwelling units in the Plan) known as __________ will be served with water by the (Name of Company or Authority).
 Signature of Owner or Developer
It is hereby certified that all lots in the subdivision (or dwelling units in the plan) known as __________ will be provided with public sanitary sewer facilities. The sewers will become part of the (Name of Company or Authority) sewerage system.
 Signature of Owner or Developer
[Ord. 215, 3/8/1976, § 1111]
Approved by the Board of Supervisors of the Township of Harmar this _____ day of __________, 20 _____.
(SEAL)
 Secretary
 Chairman, Board of Supervisors
[Ord. 215, 3/8/1976, § 1112]
Approved by the Harmar Township Planning Commission this _____ day of __________, 20 _____.
(SEAL)
 Secretary
 Chairman, Board of Supervisors
[Ord. 215, 3/8/1976, § 1113]
Reviewed by the Allegheny County Planning Commission this _____ day of __________, 20_____.
 Secretary
 Chairman, Board of Supervisors
[Ord. 215, 3/8/1976, § 1114]
Approved by the Allegheny County Conservation District this __________ day of __________, 20_____.
 Secretary
 Chairman, Board of Supervisors
[Ord. 215, 3/8/1976, § 1115]
COMMONWEALTH OF PENNSYLVANIA SS:
COUNTY OF ALLEGHENY
Recorded in the Recorders 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 __________, 20 _____.
SEAL
 Recorder