The certificates quoted below shall be inscribed on the plan
as quoted, and shall be properly signed and attested when the plan
is submitted to the Planning Commission and the Board of Supervisors.
All certificates shall be placed on final plan in an arrangement suitable
for placement of all required seals.
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OWNERS ADOPTION
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Know All Men By These Presents, that (I or We) (Name
of owner or owners) of the (City, Borough, Township) of
__________ County of __________, State of __________, for (myself,
ourselves), (my, our) heirs, executors, administrators and assigns,
do hereby adopt this as (my, our) Plan of Subdivision of (my, our)
property, situate in the Township of Charleston, County of Tioga,
Commonwealth of Pennsylvania, and for divers advantages accruing to
(me, us), do hereby dedicate forever, for public use for highway,
drainage, sewage and utility purposes, all drives, roads, lands, rights-of-way,
easements, 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, rights-of-way and easements
by said County of Tioga and Township of Charleston, (I or We), (Name of owner or owners), hereby agree to and by these
presents do release and forever discharge said County of Tioga and
said Township of Charleston, their successors or assigns from any
liability for damages arising and to arise from the appropriation
of said ground for public highways, and other public uses and the
physical grading thereof to any grades that may be established. This
dedication and release shall be binding upon (Name of owner
or owners), (my, our) heirs, executors, administrators
and assigns and purchasers of lots in this plan.
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IN WITNESS WHEREOF, (I or We) hereunto set (my, our) hand(s)
and seal(s) this __________ day of __________, A.D., 20_____.
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ATTEST:
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(SEAL)
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(Owner or Owners)
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(SEAL)
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Notary Public
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(Owner or Owners)
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My Commission expires the __________ day of __________ A.D.,
20_____.
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The foregoing adoption and dedication is made by (Name of Individual or Corporate Owner) with the full
understanding and agreement that the approval of the Board of Supervisors
of the Township of Charleston, if hereto attached, will become null
and void unless this plan is recorded in the Recorder of Deeds Office
of Tioga County, County Court House, Wellsboro, Pennsylvania, within
90 days of date of said approval.
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INDIVIDUAL ACKNOWLEDGEMENT
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COMMONWEALTH OF PENNSYLVANIA
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)
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) ss:
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COUNTY OF TIOGA
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)
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Before me, the subscriber, a Notary Public in and for said State
and County, personally came to the above names (Owner) acknowledged the foregoing release and dedication and plan to be
(his, her, their) act and deed desired the same to be recorded as
such:
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WITNESS MY HAND AN NOTARIAL SEAL this __________ day of _______________,
20_____. My Commission Expires the _______________, day of _______________,
19_____.
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CORPORATION ADOPTION
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Know All Men By Those Presents, that the (Name of
Corporation), a corporation, __________ by virtue of a
resolution of the Board of Directors, thereof does hereby adopt this
as its plan of lots of its property situate in the Township of Charleston,
Tioga County, Pennsylvania, for divers advantages accruing to it,
does hereby dedicate forever, for public use for highway purposes,
all drives, roads, lands and 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 plat and any future acceptance of said public highways by
the said Township of Charleston, Tioga County, Pennsylvania, hereby
covenants and agrees to and by these presents does release and forever
discharge said Township of Charleston its successors or assigns from
any liability for damage 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. This dedication and release
shall be binding upon (Name of Corporation) its successors and assigns and purchasers of lots in this plat.
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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 ____________________
A.D., 20______.
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(Name of Corporation)
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ATTEST:
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Secretary
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President
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The foregoing adoption and dedication is made by (Name of Individual or Corporate Owner) with the full
understanding and agreement that the approval of the Board of Supervisors
of the Township of Charleston, if hereto attached, will become null
and void unless this plat is recorded in the Recorder of Deeds Office
of Tioga County, County Courthouse, Wellsboro, Pennsylvania, within
90 days of date of said approval.
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CORPORATION ACKNOWLEDGEMENT
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COMMONWEALTH OF PENNSYLVANIA)
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)
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) ss:
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COUNTY OF TIOGA
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)
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On this ____________________ day of ____________________ A.D.,
20__ before me, a Notary Public in and for said County and State,
personally appeared (Name and Title of Officer)
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(Name of Corporation)
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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 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 of this
deponent's own proper and respective handwriting.
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(Title of Officer)
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ENGINEER'S CERTIFICATE
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I _________________________________________, a Registered Professional
Engineer (or Registered Surveyor) of the State of Pennsylvania, do
hereby certify that this plat correctly represents the lots, lands,
roads and highways as surveyed and plotted by me for the owners or
agents.
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(SEAL)
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(Engineer)
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Registration No. )
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TOWNSHIP PLANNING COMMISSION APPROVAL
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This plan of subdivision has been approved by the Planning Commission
of the Township of Charleston, Tioga County, Pennsylvania on this
____________________ day of ____________________, 20_____.
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ATTEST:
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(Secretary)
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(Chairman)
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APPROVAL BY TOWNSHIP OF CHARLESTON
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The Board of Supervisors of the Township of Charleston, Tioga
County, Pennsylvania, hereby given public notice that it is approving
this plan of subdivision for recording purposes only. The approval
of this subdivision plan by the Township of Charleston does not constitute
an acceptance of the roads, storm and sanitary drainage facilities,
easements or rights-of-way, water mains or any other services or improvements
shown on this plan nor an assumption of maintenance responsibility,
nor will the same be accepted or maintained until constructed in accordance
with all Township Specifications and requirements and officially accepted
by action of the Board of Supervisors.
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This plan of subdivision approved by resolution of the Board
of Supervisors of the Township of Charleston, Tioga County, Pennsylvania
on this ______________________ day of ____________________, 20______.
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ATTEST:
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(Board of Supervisors)
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(Chairman of the Board of Supervisors)
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SEAL:
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TIOGA COUNTY PLANNING COMMISSION REVIEW
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This plan of subdivision has been reviewed by the Tioga County
Planning Commission, Tioga County, Pennsylvania and comments presented
on this _____________________ day of ________________, 20_____.
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SIGNED:
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Director
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PROOF OF RECORDING
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COMMONWEALTH OF PENNSYLVANIA
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)
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) SS:
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COUNTY OF TIOGA
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)
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Recorded in the office for the recording of deeds, plats, etc.,
in said County, in Plan Book Volume __________ Page __________. Given
number my hand and seal this _______________ day of _______________,
20_____.
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Recorder of Deeds
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OWNERS ACCEPTANCE OF RESPONSIBILITY FOR PROVIDING
STORMWATER DRAINAGE FACILITIES AND CONTROL OF STORMWATER DRAINAGE
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KNOW ALL MEN BY THESE PRESENTS, THAT (I or We) _________________________
of the Township of Charleston, County of Tioga, Commonwealth of Pennsylvania,
for ourselves, our heirs, executors, administrators and assigns, and
for our grantees and their subsequent purchasers, do hereby accept
full and complete responsibility, liability, expense and provisions
of facilities for the control of stormwater drainage over, across
and through this subdivision of land until such time as (I or we),
our heirs, executors, administrators and assigns construct stormwater
drainage facilities in accordance with Township's specifications and
requirements and the same is officially accepted by action of the
Board of Supervisors and until such formal acceptance (I or we) for
ourselves, our heirs, executors, administrators, and assigns do hereby
release the Township of Charleston from any responsibility in connection
therewith. This acceptance of responsibility shall be binding upon
___________________________________ our heirs, executors, administrators
and assigns, and all purchasers of lots in this plan of subdivision.
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IN WITNESS WHEREOF, we hereunto set our hands and seals this
_______________ day of _____________________, A.D., 20______.
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ATTEST:
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(SEAL)
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(Owner or Owners)
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(SEAL)
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(Owner or Owners)
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Witness may hand and notarial seal this ____________________
day of ____________________, A.D., 20_____.
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(SEAL)
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Notary Public
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My Commission expires the ____________________ day of ____________________
A.D., 20_____.
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