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DANE COUNTY APPROVAL CERTIFICATE <br /> Approved for recording by the Dane County Zoning and Land Regulation Committee. <br /> Date: <br /> Authorized Representative <br /> VILLAGE OF MAZOMANIE APPROVAL CERTIFICATE <br /> Approved for recording by the Mazomanie Village Board this day of , 2014. <br /> Authorized Representative <br /> TOWN OF BLACK EARCH APPROVAL CERTIFICATE <br /> Approved for recording by the Black Earth Town Board this day of , 2014. <br /> The public highway right-of-way dedication designated herein is acknowledged and accepted by <br /> the Town of Black Earth. <br /> Authorized Representative <br /> OWNERS CERTIFICATE <br /> Harold W.and Betty C. Spahn,as owners, hereby certify that we caused the land described to be <br /> surveyed,divided, dedicated and mapped as represented on the map.We also certify that this certified <br /> survey map is required by S.75.17(1)(a), Dane County Code of Ordinances to be submitted to the Dane <br /> County Zoning and Land Regulation Committee for approval. <br /> Harold W.Spahn Date <br /> Betty C. Spahn Date <br /> STATE OF WISCONSIN) <br /> COUNTY) )SS <br /> Personally came before me this day of ,2014,the above Harold W. <br /> and Betty C.Spahn to me known to be the person who executed the foregoing instrument and <br /> acknowledged the same. <br /> `,mini///, <br /> NSANotary Public ,Wisconsin SG �r <br /> My commission expires: ' DAM-A.{t. <br /> S1 <br /> DEFOREST <br /> N . S A <br /> ''�.,Q SUR� .� <br /> SHEET 3 OF 3 <br />