KNOW ALL MEN BY THESE PRESENTS: that _________________________________, whose address is
_________________________________________________________, party of the first part, for and in
consideration of the sum of One Dollar ($1.00) paid to it by the City of Farmington Hills, whose address is
31555 Eleven Mile Road, Farmington Hills, Michigan, 48336-1165, party of the second part, does hereby
grant to the said party of the second part of the right to construct, operate, maintain, repair and/or replace a
____________________________________ across and through the following described land located in the
City of Farmington Hills, County of Oakland and State of Michigan, to wit:
And to enter upon sufficient land adjacent to said for the purpose of construction,
operation, maintenance, repair and/or replacement thereof.
The premises so disturbed by reason of the exercise of any of the foregoing powers shall be reasonably
restored to its original condition by the party of the second part.
This instrument shall be binding upon and inure to the benefit of the parties hereto, their heirs,
representatives, successors and assigns.
IN WITNESS WHEREOF, the undersigned parties hereunto affixed ______________ signature(s) this
__________ day of ______________________, A.D., 20 ____.
Signed in presence of:
* NOTE: Please print name under signature
STATE OF ________________ )
COUNTY OF ______________ )
On this ______ day of _________________, A.D., 20____, before me, a Notary Public in and for said
County, personally appeared _______________________________________________________, to me
known to be the same per