Whereas _________ and _________ are owners of two certain lots of land situated on _________ side of _________ street in the city of _________, being lots numbers _________ and _________ on the plat of land on _________ surveyed _________, _________[date], by _________; and the parties, considering that it will be a benefit to the owners of the two lots of land to lay out a twelve-foot gangway between the lots of land, do, for themselves, their several heirs, executors, administrators and assigns, covenant and agree each with the other, for the purpose of making a gangway, _________ shall throw off from the lot of land owned by [him or her] six feet to be measured off from the west end of [his or her] lot of land, commencing on _________ street and extending back northerly _________ feet, and that _________ shall throw off from the lot of land owned by [him or her] six feet, to be measured off from the east end of [his or her] lot, commencing on _________ street and extending back northerly _________ feet. The gangway is to be kept open for the joint use and benefit of _________ and _________, their heirs and assigns, and not to be shut up or have any buildings built on it without the consent of _________ and _________, their heirs or assigns.

In witness whereof we have hereunto set our hands and seals, etc.