Subdivision Application, Review and Approval
“On this, the (day) day of (month) , (year) , before me the undersigned, personally appeared (name of applicant) , who being duly sworn according to law, deposed and says that he is the (1) of the property shown on the plan, that the subdivision plat thereof was made at his/its direction, that he acknowledges the same to be his/its act and plat (2) , and that all streets (3) shown and not heretofore dedicated to the public (4) (5) (6) (7) (8) (9). My commission expires: |
“I hereby certify that I am a Civil Engineer/Surveyor registered professionally to practice in the State of West Virginia and that this plat is, in all respects, correct and was prepared from an actual survey completed by me on , . Signed . Seal Reg. No. . |
Owners Date Planning Commission President Date |
Subdivision Application, Review and Approval
“On this, the (day) day of (month) , (year) , before me the undersigned, personally appeared (name of applicant) , who being duly sworn according to law, deposed and says that he is the (1) of the property shown on the plan, that the subdivision plat thereof was made at his/its direction, that he acknowledges the same to be his/its act and plat (2) , and that all streets (3) shown and not heretofore dedicated to the public (4) (5) (6) (7) (8) (9). My commission expires: |
“I hereby certify that I am a Civil Engineer/Surveyor registered professionally to practice in the State of West Virginia and that this plat is, in all respects, correct and was prepared from an actual survey completed by me on , . Signed . Seal Reg. No. . |
Owners Date Planning Commission President Date |