HomeMy WebLinkAboutBOS 20171024001228Instrument Number: 20171024001228 Document:BS Rec: S77.00 Page-1 of 4
Record Date:10/24/2017 3:54 PM
Electronically Recorded King County, WA
Return Address:
City Clerk's Office
City of Renton
1055 South Grady Way
Renton, WA 98057
BILL OF SALE
Please make no inark in the Ynargin space - Reservedfir County Auditor's Use Only
TYPE OF DOCUMENT: Bill of Sale
G NTOR(S): Summit Petroleum Group
GRANTEE: City of Renton, a
LOT 4 E%C NW 160.42 FT THEREOF AND UNDIVIDED INTEREST IN
TRACT "A" KING CO SHORT PLAT NO L99S3019 RECORDING NO
20010831900002 BEING A PORTION OF NE QT.R SW QTR STR 23-23-
ABBREVIATED LEGAL 05 (AKA LOT "B" CITY OF RENTON LOT LINE ADJUSTMENT NO
DESCRIPTION: LUA-I2-000193-L,LA RECORDING NO 2013061.1900014)
ASSESSOR TAX PARCEL I.D. NUMBERS: 232305-9211
NAME OF PROJECT: Cedar River Station. - Fueling Station
ADDRESS OF PROJECT: 15355 Maple Valley Hwy
PROJECT FILENUMBERS: LUAN(A, UU15005162, PLR-3884
LEGAL DESCRIPTION: See Attached Exhibit A of this Document
PERSONAL PROPERTY DESCRIPTION: See Attached Exhibit B of this Document
Reference Number(s) of Documents assigned or released:
Additional reference #'s on page _- of document
The Grantor, as named above, for, and in consideration of mutual benefits, hereby grants, bargains, sells and
delivers to the Grantee, as named above, the following described personal property as described in Exhibit B
of this document:.
By this conveyance, Grantor will warrant and defend the sale hereby made unto the Grantee against all and
every person or .persons, whomsoever, lawfully claiming or to claim the same. This conveyance shall bind
the heirs, executors, administrators and assigns forever.
IN WITNESS WHEREOF, said Grantor(s) has caused this instrument to be executed this _ day of
?c: 20
r
By � a '�:^ .. � By
1�
Its Its
Instrument Number: 20171024001228 Document:BS Rec: 577.00 Page-2 of 4
Record Date:10/24/2017 3:54 PM King County, WA
BILL OF SALE
Page 2
Project File Number: LU /A, UU15005162, PLR-.3884
Notary Seal must be within box
INDIVIDUAL FORM OFACKNOWLEDGEMENT
STATE OF WASHINGTON ) SS
COUNTY OF KING }
I certify that I know or have satisfactory evidence that,,,,_
signed this instrument and
acknowledged it to be his/her/their free and volumtary act for the uses and purposes
mentioned in this instrument.
:Notary public in and for the State of Washington
Notary (Print);
My appointment expires:
Dated:
PRES°ENTATIVE FORM OF, A CKIVO WI EDGE E.7VT
Notary Seal must be within box
STATE OF WAS14INGTON ) SS
COUNTY OF KING )
I certify that I know or have satisfactory evidence that..__..__..__...,_,..._m,,.a.__ ..._..__.,._.
s➢gmed this instrument, on
oath stated that he/she/they was/were authorized to execute the instrument
and acknowledge it as the and
of to be free and
voluntary act of such party/parties for the uses and purposes mentioned in the
instrument,
Notary Public in and for the State of Washington
No (Print):
My appointment expires: _
Dated:
CORPORA r,OR OF A CKNOWLEDGE ENr
Notary Seal must be within box
STATE OF WASHINGTON ) SS
�tItRI I
9 liI,
COUNTY OF KING }
On this A_.._ day of ._t"s,�.., 20 17 before me personally appeared
d to me known
¢
tttta o. a, a
r'.
tal-e.....
of the corporation that
01A54 fir" ,, ,
', e.cuted the within instrument, and acknowledge the said instrument to be the free
i
➢d voluntary act and deed of said corporation, for the uses and purposes therin
I
tr t "i C)
entioned, and each on oath stated that he/she was authorized to execute said
r
rd ra
➢tastn➢snent and that the seal afflxed➢S doe corporate seal of Said corporation.
a
Notary Public in an 'or the State of Washington
i�Iatary (Print): �➢ % t
_.m._.:
My appointment expires:.,/ l
Dated:
Instrument Number: 20171024001228 Document:BS Rec: S77.00 Page-3 of 4
Record Date:10/24/2017 3:54 PM King County, WA
BILL, OF SALE
Project File Number: LUA,N/A, UU15005162, PLR-3884
EXHIBIT A
Instrument Number: 20171024001228 Document:BS Rec: 577.00 Page-4 of 4
Record Date:10/24/2017 3:54 PM King County, WA
Return Address. -
City Clerk's Office
City of Renton
1055 South Grady Way.
Renton, WA 98057
PROJECT NAME:
CONSTRUCTION PERMIT NO.
PROJECT FILE NUMBER:
t(.,Ity start use Only)
EXHIBIT "B"
Contributary Assets
Cedar River Station - Fueling Station
U15005162
N/A
Per the request of the City of Renton the following information is famished concerning final costs for
improvements installed and turned over to the City for the referenced project.
QTY UNIT
Curb and Gutter
0 L.F.
$
0
Sidewalk
0 S.Y.
$
0
Asphalt Concrete Pavement
0 S.Y.
$
0
Monument Case and Cover
0 EA.
$
0
Traffic Signs - Complete System
0 L.S.
$
0
Number of Luminaires and Poles
0 EA.
$
0
Subtotal
$
0
Sales Tax
$
o
Grand Total Roadway, Street Lights and Signals
0
STORMWATER SYSTEM IMPROVEMENTS
TY UNIT 512E TYPE DESCRIPTION TOTAL COST
20 ft 12" PVC ULV T 460
Subtotal $ 460
10% Saps Tax 46.0
Grand Total Stormwater System Improvements 506