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FORM NO.945-A <br /> Stock No. 26273 000350 <br /> TOWN OF BRISTOL APPROVAL CERTIFICATE <br /> Approved for recording by the Bristol Town Board. The public <br /> highway right-of-way dediratioti hereon is acknowledged and <br /> ! ' ` <br /> accepted by the Town of Bristol this 4 <br /> day of <br /> P RP4,e y , 1 9 97. <br /> ill `g f_____:L_—... eAdit <br /> Authorized Representative <br /> Bristol Town Board <br /> OWNER'S CERTIFICAT <br /> As owner 's we hereby certify that we caused the land described to <br /> be surveyed, divided, mapped and dedicated as represented on the <br /> map. We also certify that this certified survey map is required <br /> by S. 75. 17( 1 ) (a) , Dane County Code of Ordinances to be submitted <br /> to the Dane County Zoning and !Natural Resources Committee for <br /> approval . <br /> �C • <br /> Dated this ________ day of _ d , 1992. <br /> } <br /> 'ji-tii,,..01/(— 6,2e( L...,—• . / - , -‘��-" ,.._/Kenneth B. Gilbertson <br /> Anne Gilbertson <br /> STATE OF WISCONSIN) <br /> �- COUNTY)SS <br /> Personally came before me this to day of <br /> 199"1, the above Kenneth B. Gilbertson and June E. Gilbertson to <br /> me known to be the persons who executed the foregoing instrument <br /> and acknowledged the name. <br /> \62...1 <br /> Notary Public D"+-.�_.._ <br /> _, Wisconsin <br /> My commission expires : VCR- `R <br /> CQAKa , '1 <br /> . t A. <br /> =• I % <br /> „11. .i'• <br /> R <br /> "4..,,,SU \,t� <br /> PAGF 3 OF 3 <br /> • <br />