Skip to main content
Loading…
This appendix is included in your selections.

Dedication

The owner of the land described herein in fee simple is _________________________ and The owner declares this plat and dedicates to the public forever, all streets, roads, alleys, easements or whatever public property there is shown thereon for any and all public purposes not inconsistent with the uses shown on this plat.

Dated ______________________

Signed_______________________

Acknowledgment

State of Washington

County of Grant

I certify that I know or have satisfactory evidence that __________________________ signed this instrument and acknowledged it to be his/her and voluntary act for the uses and purposes mentioned in the instrument.

Dated_______________________

(Seal)

____________________________ Notary Public

____________________________Print or Type Name of Notary Public

My appointment expires ________________________

Surveyor's Certification and Declaration

I hereby certify that this plat is a true and correct representation of the lands actually surveyed.

I hereby declare that the plat of ____________________________ is based on actual survey and subdivision of a portion of Section ____Township_____North, Range_____East, W.M. that the distances and courses and angles are shown thereon correctly to the best of my knowledge, information, and belief; and that proper monuments have been set and lot corners are staked on the ground.

_______________________

Licensed Land Surveyor

(Seal)

EXAMINED AND APPROVED by the George Public Works Department on _________________, 2_____.

City Engineer or Public Works Director

EXAMINED AND APPROVED by the Planning Authority on

______________________, 2_____.

__________________________

Planning Authority Chairman

EXAMINED AND APPROVED by the George City Council on

______________________, 2_____.

___________________________

Mayor

ATTEST:

____________________________

City Clerk

This is to certify that all taxes and assessments which are now due and payable according to the records of Grant County have been fully paid.

___________________________

Grant County Treasurer

___________________________

Date

Filed for record at the request of the City of George this ___day of ________________,2____ at ______ ____., and recorded in Volume of Plats, on Page ___, records of Grant County, Washington.

___________________________

Grant County Auditor

_________________________

by Deputy Auditor