The applicable portions of this certificate shall appear on all plats.

        We, the undersigned _________ (names)__________ owners of the real estate shown and described herein, do hereby certify that we have laid off, platted and subdivided, and do hereby lay off, plat and subdivide, said real estate in accordance with the within plat.

        The subdivision shall be known and designated as ________________________ consisting of _______________________ lots and _______________________________ blocks and containing ____________________________ acres.

        All streets and alleys shown and not heretofore dedicated are hereby dedicated to the public. Other public lands shown and not heretofore dedicated are hereby reserved for public use.

        Clear title to the land contained in this plat is guaranteed. (Any encumbrances and special assessments are explained as follows):

        The setback lines shall be determined by the regulations of the Columbus, Indiana Zoning Ordinance of current adoption.

        There are strips of ground shown on this plat and marked easement, reserved for the use of public utilities and subject to the paramount right of the utility or City to install, repair, maintain or replace its installation.

        All drainage easements identified on the plat are specifically authorized to be used for drainage purposes. All grades shall be maintained as constructed. Additional cut and fill work within drainage easement areas is prohibited unless authorized by the Engineering Department.

        WITNESS OUR HANDS AND SEALS this ________________________ day of ______________________, __________.

        Before me, the undersigned Notary Public, in and for the County and State, personally appeared ______________________________ and each separately and severally acknowledged the execution of the foregoing instrument as his or her voluntary act and deed, for the purposes therein expressed.

        Witness my hand and Notarial Seal this ___________day of _____________________, ________.

    ____________________________________________

    Notary Public                 (Seal)

(Ord. 99-24 § 3 (part), 1999; prior code § 28-74)