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 governing body. All certificates shall be placed
on the final plan in an arrangement suitable for placement of all
required seals.
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(1)
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OWNER'S ADOPTION
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KNOW ALL MEN BY THESE PRESENTS, THAT (I or We) ____________________________________________________________
of the
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(Name of Owner or Owners)
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Township of Robinson, County of Washington, Commonwealth of Pennsylvania, 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 Robinson, County
of Washington and 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,
streets, 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 Washington
and Robinson Township.
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(I or We),
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(Name of Owner or Owners)
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hereby agree to and by these presents do release and forever
discharge said County of Washington and said Township of Robinson,
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
(my, our) heirs,
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(Name of Owner or Owners)
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executors, administrators and assigns and purchasers of lots
in this plan.
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IN WITNESS THEREOF, (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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(Owner or Owners)
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(2)
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FOR MINOR SUBDIVISIONS
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3.1 OWNERS ADOPTION
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KNOW ALL MEN BY THESE PRESENTS, THAT (I or We) (name of individual
owner) of the TOWNSHIP of ROBINSON, of the COUNTY of WASHINGTON, 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, situated in the Township of
Robinson of WASHINGTON COUNTY, Pennsylvania.
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IN WITNESS WHERE, (I, We) hereunto set (my, our) hand and seal
this __________ day of __________ 20_____
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ATTEST:
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Notary Public
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Owner
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(3)
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INDIVIDUAL ACKNOWLEDGMENT
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COMMONWEALTH OF PENNSYLVANIA
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SS
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COUNTY OF WASHINGTON
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Before me, the subscriber, a Notary Public in and for said State
and County, personally appeared the above named
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(Owner)
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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:
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Sworn to and subscribed before me the day and date written.
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WITNESS MY HAND AND NOTARIAL SEAL this _____ day of __________
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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OWNER'S/CORPORATION'S CERTIFICATION
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I or We,, owner
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(Name of Owner or Owners)
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of the ____________________ Subdivision _____, do hereby certify
that the title of this property is in the name of ____________________
as recorded in DEED BOOK VOLUME _____, PAGE _____, RECORDER OF DEEDS
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OFFICE. We further certify that there is no mortgage, lien or
encumbrance against this property.
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Witness
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Owner
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Witness
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Owner
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(4)
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1:2 CORPORATION ADOPTION
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KNOW ALL MEN BY THESE PRESENTS; that the (name of corporation),
a corporation incorporation under the laws of the Commonwealth of
Pennsylvania, by virtue of a resolution by the Board of Directors,
thereof, does hereby adopt this plan as its (Plan of Lots, Land Development)
of its property situate in the Township of Robinson, Washington 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, street, lanes, and other 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 commonwealth of Pennsylvania, County of Washington,
and Township of Robinson.
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(name of corporation), hereby covenants and agrees to and by
these presents does release and forever discharge said Commonwealth
of Pennsylvania, County of Washington and Township of Robinson, their
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, units) in this plan.
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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
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____________________ day of ____________________ 20_____
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ATTEST:
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NAME OF CORPORATION
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(SEAL)
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Secretary
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President
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(5)
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CORPORATION ACKNOWLEDGMENT
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COMMONWEALTH OF PENNSYLVANIA
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SS
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COUNTY OF WASHINGTON
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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
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(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 the deponent subscribed
to the said release and dedication as
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of said corporation,
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(Title of Officer)
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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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(SEAL)
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(Name of Officer)
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(Title of Officer)
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Sworn to and subscribed before me the day and date written.
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WITNESS MY HAND AND NOTARIAL SEAL this __________ day of _______________
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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(6)
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B. To be used for partnerships. A general
partner must sign.
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The (NAME OF PARTNERSHIP), (OWNER OR BENEFICIAL OWNER) of the
land shown on the (NAME OF PLAN) hereby adopts this plan as its (PLAN
OF LOTS OR LAND DEVELOPMENT) and irrevocably dedicates all streets
and other property identified for dedication on the plan to the (municipality).
This adoption and dedication shall be binding upon the partnership
and upon its heirs, executors and assigns.
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IN WITNESS OF WHICH, to this (I/WE) set (MY, OUR) hand and seal
this ____________________ day of ____________________, 20_____.
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ATTEST:
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Notary Public
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Signature of General Partner
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(7)
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OWNERS' ACCEPTANCE OF RESPONSIBILITY FOR PROVIDING STORM
WATER
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DRAINAGE FACILITIES AND CONTROL OF STORM WATER DRAINAGE
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KNOW ALL MEN BY THESE PRESENTS, THAT (I or We) ________________________________________,
of the Township of Robinson, County of
Washington, 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 provision of facilities for
the control of storm water drainage over, across and through this
subdivision of land until such time as (I or We), our heirs, executors,
administrators and assigns construct storm water drainage facilities
in accordance with Township specifications and requirements and the
same is officially accepted by action of the Governing Body and until
such formal acceptance (I or We) for ourselves, our heirs, executors,
administrators and assigns do hereby release the Township of Robinson
from any responsibility in connection therewith. This acceptance of
responsibility shall be binding upon
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,
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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 My hand and notarial seal this __________ day of _______________,
A.D., 19_____.
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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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(8)
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FOR ALL SUBDIVISIONS
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2.1 TITLE CLAUSES
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(I, 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, We)
further certify that there no mortgage, lien or encumbrance against
this property.
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Witness
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Owner
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2.2 TITLE CLAUSE (Having Mortgage or Encumbrance).
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(I, 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.
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Witness
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Owner
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(I, We) __________ (name of mortgagee) _______________ mortgagee
of the property embraced in this __________ (name of plan) __________
as recorded in Deed Book Volume) __________, Page __________ Record
of Deeds Office.
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Witness
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Mortgagee
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2.3 SURVEYOR'S CERTIFICATION
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I ____________________ A Professional Land Surveyor of the Commonwealth
of Pennsylvania, do hereby certify, to the best of my knowledge, information
and belief, that this plan correctly represents the lots, lands, streets
and highways as surveyed and plotted by me for the owners or agents.
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(SEAL)
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(9)
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HIGHWAY OCCUPANCY PERMIT REQUIREMENT
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This plat requires a Highway Occupancy Permit pursuant to Section
420 of the Act of June 1, 1945 (P.L. 1242, No. 428), known as the
"State Highway Law." Approvals of the Township of Robinson Planning
Commission and the Township Board of Supervisors are conditional,
subject to action of the Pennsylvania Department of Transportation
pursuant to application for a Highway Occupancy Permit.
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(10)
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WASHINGTON COUNTY PLANNING COMMISSION REVIEW
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Reviewed by the Washington County Planning Commission.
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this __________ day of _______________, 20_____.
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(Director)
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(Chairman)
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RECORDING REQUIREMENT
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The foregoing adoption and dedication is made by
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________________________________________ (Name of Owner or Owners)
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________________________________________ with the full understanding
and agreement that the review of the WASHINGTON COUNTY PLANNING COMMISSION,
if hereto attached, will become null and void unless this plat is
recorded in the RECORDER OF DEEDS OFFICE of WASHINGTON COUNTY, WASHINGTON,
PENNSYLVANIA, within 90 days of date of said review.
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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 WASHINGTON
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Recorded in the Office for Recording of Deeds, Plats, etc.,
in said County, in Plan
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Book Volume __________, page __________.
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Given under my hand and seal this __________ day of _______________,
20_____.
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Recorder of Deeds
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(11)
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RECOMMENDATION OF THE ROBINSON TOWNSHIP PLANNING
COMMISSION
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This plan of lots has been reviewed and approval recommended
by the Robinson Township Planning Commission this __________ day of
__________, 19_____, subject to the provisions and/or conditions in
the Planning Commission's letter to the Board of Supervisors
dated __________, 20_____.
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Secretary
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Chairman Planning Commission
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(12)
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APPROVAL BY THE ROBINSON TOWNSHIP BOARD OF SUPERVISORS
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The Board of Supervisors of the Township of Robinson, Washington
County, Pennsylvania hereby approves this plan of subdivision for
recording purposes only. This approval by Robinson Township does not
constitute an acceptance of the roads, streets, storm and sanitary
drainage facilities, easements or right-of-ways, 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 Governing Body.
This approval shall in no way be deemed an authorization to commence
construction or related activities. This plan of subdivision approved
by resolution of the Governing Body of the Township of Robinson, Washington
County, Pennsylvania
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on this ____________________ day of_________________________,
20_____.
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ATTEST:
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Secretary
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Chairman, Board of Supervisors
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SEAL:
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