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WTR2701085
W- 1095 Cedar Rim ADts, Fire Sprinkler. ✓i l � • }r ) r ' i ' I I 1� a F A� N Im WIR 27 WATER PROJECT W-1OBS -Coda, Rie. Apts Fire SPrie4ler Peewit Nuelpa P. W O._ Dale Iouelk _ Date Lxpl,o heacoo Mectley Datc Special Billie{ Y N � ly N/A .:,3�, hmen Tat plc �+,f�seuefe�{ery 3Y' N i.. ritY Tool Detc� _ �, ,iY �/�,_, yNllt'p Dnwm Siaud. Biu of Sale/Verified :../` Y :N'r`•\ `il,J;RerdrdM e`: Leuaeat/Verifled Y N_ Receded a Oa? x6'm-106C• Cot Dun la•.WM/Verified If_ _ N Receded�r Backnn-lot report/Laedeape: Y� N N/A Fio haanioa: Y N_'N/A 1.e''FLal�Aooep=Cll Bylorpeeter f-�+¢. � f' ` 1 :St y lady i • D UUH a l r 1 e ,,a. l• ems. 1_ COST DATA AND INVENTORY SU�jECT: G6heic tr„,, A('f5. CITY PROJECT NUMBFRS. W- 1005 �. NAMESYsTCnn S UA ST- t;e TO: CITY OF RENTON FROM: '197.ia -IIOTH k-vm SE it ' UTHITIES DIVISION 200 MILL AVENUE SOUTH yne r rb.1 i VV A- RENTON,WA 98055 DATE: l( • 'Lw -9 3 Per your request,the following infortmtion is furnished concerning costs for Improvements installed for the above referenced project. WATER SYSTEMt Length Size Type Zo LF.OF 4" tr 1 _ WATERMAIN L.F.OF WATERMAIN L.F.OF WATERMAIN L.F. OF WATERMAIN i EACH OF GATE VALVES EACH OF GATE VALVES EACH OF GATE VALVES SUBTOTAL $ -1 'LO°c _ EACH OF __ FIYE HYDRANT ASSEMBLIES $ (COST OF FIRE HYDRANTS MUST BE LISTED.;F,',RATF.LY). en TOTAL COST FOR WATER SYSTEM $ 1�' SANITARY SEWER SYSTEM: Length Size T)w _ L.F. OF SEWER MAIN _ L.F. OF SEWER MAIN L.F.OF _ SEWER MAIN EACH OF DIAMETER MANHOLES -- TOTAL COST FOR SANITARY SEWER SYSTEM $ STORM DRAINAGE SYSTEM: Length Size Type i. L.F.OF STORM LINE LE OF STORM LINE L.P.OF STORM LINE EA.OF STORM INLET EA.OF ' -- STORM CATCHRASIN E.A.OF STORM CATCHRASIN TOTAL COST FOR STORM DRAINAGE SYSTEM STREET IMPROVF,V : (Including Curb,Gutter,Sidewalk,Asphalt Pavement and Street Lighting) TOTAL COST FOR STREET IMPROVEMENTS $ f)/%L l �.ni . t:f.P Ma.uA4(�n�evr" (SIGNATURE) (SIGNATORY MUST BE AUTHORIZED AGENT OR OWNER OF SUBJECT DEVELOPMENT) �r t Me{FIDE LAO CMwwYWn ■..AYY.M.nwM.s )]I nrn.ann 9�.«a SwMe,VYrAYgiar hM�1y0i Yad YM p94w Y M eorNnri-�a am IYMIYAgi'MM�tiv1W11 MKIYT y!n Y ' . t UTILITIES A:FM� THIS INSTRUMENT, made this 9 rr day of an"/ 19 qL: and t by and between G:rx r and ac /� F: _ and _ _ and the CITY OF RENTON. a Municipal Corporation of King County,Washington. hereinafter canal 'Grontor(s),' and hereinafter called 'Grantee.' tiITNESSETH: That said Grantor(s),for and in consideration of the sum of S paid by Grantee, and other valuable comidustion,receipt of whirls is hereby sckno wledgsd,do by these presents,grant,bargain, sell,convey,and warrant unto the said Grantee,its successors and assigns,an easement for public utilities(including water and sewer)with necessary appurtenances over,through, across and upon the fcilowing described property in King County,Washington,more particularly describe)as follows: r. See Exhibit A - Legal. description Sae Exhibit B - Survey of Property I/a112 C41UMTBN!"h U e I t n 11 Tut ,1_:0a LHNPLIGHTEF FHF4. 066448022 ing ce of p Saki heretofore mmnon:d gremee,Its cce"0t'rs of 1 said above de+cribed P uP ty for the D rposl have the fight,without Prior e of comtructen➢' at law, at such tlmei as may be necessary P without iocurring maintaining,rupsiring,alter has or[ OMETUesime said utilities,or tttakN➢any conOrrb li, a airng,Altering or any legal obll➢aslons a liability Mere[em,provided,that such construction.maWainir+g,repairing, existing in Me _ rernluuuction of t'!d utilities shall be aecompilshed In such ll i C�a�ua p 900�e�odi[irc as they were immediately shall a proot be CMdist Wad Or damaged, pon by Me Orantee Immedluolp bdbte Me property the I%Grantor shall fully use and ARM Me aforadescribed pl emiseadoes not inte:fwa with ,including the right to revin Me right a use However, e atic;,1 Ind the,Buthre re of aid dght-of-v%Y if sud'eat not anti hogdhrgs or suvaurea over, nder or terol$a the right-of twayy dung The Of tie orht nce of sucA dtiltttes. and This easemnr,shall be a coveam r Riling s la Me land and,hail be bt p ng bnm a d tthat d y hate A li r,d and � aeaigns. OCIAMra covenant that theyera the lawful owners of Me above ropers: i 18*U right to execute is agrtomnt. UnBPQRATEF�'AdM:�. STAT3 OF�s //.a-- � SS COUNTY of on of_/,6(�fL,l' _ 19_[.(,.before me,the undersigned, x Notary Public in and for the State of �j _ `�_`L duly a h n w rn error. Y appeared and --`T.to me known be th � ... .eapectively,dt-(�Q�i�7(�jy�yK,- •torpor that used Me[oeegoiag,lnst,unreM.nod'• acknowledg-d nc�sal" d inl61M to be the and untafy atx sd d of said c rattan,h[the use gird v ►ylhorizod to cantata the,aid purFoses therein mentioned,and on oaM stand se+1 of said erirpora on. instrument and that the neat Affixed I,Me corporate WITNBSS my hand and ofrS id seat heteto affixed the day and year to this certlt5:91e ab.v.s written. x f_ r: A, WEhOY G HENLEY Notary Public n azwi for Ms nr+,runts mr.a r.ur of :> W famnrson E Vrr ras% Gv2r2 APR- v-YI 1UE 1.:04 L..MPLIwH1ER PAR,, 2066440022'_- P.04 k HEBRANK Fxr,lrlt nqa A '` Aihcn J.R PLS UJor P.W.msock,n,PLS " ASSOCIATES Professimat.2umtyors 0 CemtaJ Au_4du%_Suit4 355,810-9td Avenue U Seattle WA 98104_ CJ �2it67-W__7_•1720 �— 8 April 19VI Pit* No. 91035 WAMN LlkF FAAEMENT MW—RIPTION An e49em0nt for water utility purpusea over , &grass, under and throuyh all that portl On of Tract ]bb of C. 0. Hillman's Lake } Wasltinyton baronn of EOsn Addition to *attle, thvlvau^ No. S, as per plat raLorded In Volume 11 of Plat%, Page Hit recordw of King County, Washington, described 4% 101 Iow31 Commencing at or, •nca'trq at the Y9wthwe%t corner of the northoast quarter of SWLtao.� 79. Townwhiw 24 North, Range 5 Cast, W.H. J tmPmCW South eB- 41 17' 6".1. the south line of sold northeast quarter "S.29 feet to an er-.ca." monument marking tr,w intV,-sertion of N.E. 43rd place lal so kno.on as S.t. hOth Street) and Lidvin 4venue N.E. 1 thpl'4W ccntanuing 80„th 68' 47' 11" East C4.44 twat; thence North 1' 17 43" Ea:t 122.97 toot to Chu northeast curnwr of a buila Sng and -he True Point of Beginning of this easement drw, iptio�l thence North 8R- 2-' 00" West slang the nortnerly wall of Salo ouilding 13.5 foot to an angle polat thereint thence North 1. 35 VO" foot along said well 2.6 feet to an angle point therein; thane• 3uuth W 2't' 00" East pafallwl with said bullding 13.5 foot$ tr"W,�W South 1' 35 00" West 2.6 fvot to the Trot, Feint. of Region yogi rCSEIHtH WITH an .4sement for water utlflty purposes o'er, atrues, under and through ell Lhut F..vtlon Of Said Trar.t 16l, lying within a 10 foot strlp Of land, being 7.r0 feet Oo •aCh wide of the CVntreline of a water mill, which rentrellma 14 de►erlhdd an fnllowsl sagioniny at. ♦ point on the ncrth sadff of thV $fur erirwr•rl bntl easement lyi�,g North ©S- 25' 00" Wwst H.2 feet from the northeast corner tnere7i1 tnenre North 3' 79 04" East along said water mein 3.S3 feet to an aryl• point trier rip; thence No, tl� 88. 08 00" East a:0,g 'aid water main 29.5 fast to it' 1"LVr wer ties Witt, a wrier supply main and thy e4sturiY cocoas Is of tht: QasF'.wnt. �1r�NR'rM:M Jh_ - _ . _.«... • .r......•n�'1�'MVIQ1ft 1M MopGua x f 3 wFR- 9-91 TUR 12104 LRMPLIGMTRR PARK 2066440622 P.®4 Y1 11'3* $2ue 042 2623 DUDU PACIFIC SK HEBRANK AND AW141 HtbaAk.PtS ise P�klne":.P15 ASSOCIATES PTotescmn !surwyMA C Central]Building Suitz 355.R10.3fa Avenue :') Se"n!e,W'A 491G9 rJ (206)447.1729 C6es,»cnf 1 h of A,...lT f� ! 'v j �,in! of Cb.n..,c..c,.:a .�,.�w•• 7. fs..ts, rt{.r, •�, seise � J: � 4 I � C Ar-^i I/ l9�r • %•1, No. fe,>Jf ExhIDIT RAPER LINT 1111,$9MLNT DZSCR:PTION .. � - s• :,mow: r . :x -� CITY OF RENTON j PUBLIC WORKS DEPARTMENT y Earl Clymer, Mayor Design/Utility Engineering BACKFLOW PREVENTION DEVICE REPORTING ANu TESTING INSTRUCTIONS All Backflow Prevention Devices installed are required, by Washington State Law (RCM 42.20.050.83-19-002;WAC 248-54-195), to be tested on installation, and annually thereafter. Testing must be done by a Tester certified by the State of Washington Department of Social and Health Services, A list of whom may be obtained from this office. Please complete the bottom of this form, and return it to the Uti, ty Engineering Department at 200 Mill Ave. S., Renton, MA 98055, together with the completei Test Form(s) attached, when the required device(s) have been installed. p A OWNERS MAILING INFORMATION OWNER'S NAME: /#U . /a." /4y S. MAILING ADDRESS: '/7J1;" /iOmA,-e :�CE. DEVICE LOCATION INFORMATION STREET ADDRESS: s... •-+- ;.... DEVICE LOCATION*: CONTACT PERSON: L� .-t(ai,a- �YtedFsz PHOYE NUMBER: 276/35Z PROTECTION ZONE+: DATE INSTALLED:_ _ _ USER CODE+: NETER SIZE: a/" METER MAKE: JL4iLot SERIAL NO: lX6 Fa y __ • Directions to the device on the premises. (eq. Second Floor utility room (Rm 209) next to elevator. ror + To be completed by Utilities Personnel. U/M/BKFLPREV ` 200 Mill Avenue South• Renton, Washington 91I055 -(206)235.2631 .3 Ii 4 A } Ul kt a 6 El ► PUBLIC WORKS DEPARTMENT 'A F DESIGN/UTILITY ENGINEERING 0 235-2531 �Y MUNICIPAL BUILDING 200MILLAVE.E0. RENTON.WASH.SWISS y �YPIf� " ""•.:,' . BACKFLOW DEVICE TEST REPORT 2 —_ ` t r4ew+t R. o.+nY .eNee en MM ,!. Nrr.1Cr.JOr1YM �K`V /u"e+\ �9J6 i/QL,1.< Sf- A4.,Wo _ Lvw rr8v s� l0ee+ewb aw aerN J vGZ QA M MNIRR.....IN IRRNRe IRl wN CHECK VALVE NO.t CHECK MLVE NE, W E DIFFERENTIAL PRE/ M IIELIEP VALVE __— _ INITIAL I LHYee ... 1 LeaAae I D 81 De TEST neat"weelur0 x C Wngnl.................. ❑ E CbweSEW.................. ❑ E Dre.NePer+ ... .......". . ❑ S of ---- CNenee_...................... 6A CYenle........................ 1K CYNnee....__......__.._.. ❑ ReWcatl Amplacetl P Wecee SPrrnp .. ...... .. . ... ❑ SPrrnq ... ..... ❑ R PrnreLrrlM .... Pec r q.M _".. .._.... ❑ GuM. .. ❑ Gwee ❑ SPnnyp J eWM ...... ❑ Dnpbepm 4rpl ❑• 11mge Pm .. ❑ Nmpe pn................— ❑ WDer .. ❑ ❑ Seat ..... ❑R .................. ❑ V.9 E DUPMepm . . .. ❑ M,h",m ._...... ❑ de nn m.emeY Otlyr,aeecnte. ._. ... ❑ dne:A""" ❑ upeer ❑ L..a ... ... r❑) OrMr.tlescrrb ........., ❑ FINAL Gbwtl upnl 1N DYaMEEN.._................ OPenNN b TEAT +EO1cN NHeun r HEAIOVEAEPOIIi NCE Di TRUE 'Y.. MIUMIMMMr rO qYl ' i Public Works Department DESIGNIU1 Il.I EY ENGINEERING — "` 200 Mill Avenue South d + n Renton. Washington 98055 fAN1•''' '•� nut -- �r T + * 1e { r a `9 M g Y� I I 3373 IrrORDER FOR ,fWATER SERVICE INSTALLATION ND I 'Nak oraa N." n Sl ` i AMI N— -- MWr Clwq $ Swdry SM No. law&oh Beniw C.rMX In City Yw❑ Non on Sean Y. Down Psyaatenl Went U.,e'. ❑p0aaenaa Domes"D Spea•I Uwy Conm .Ch.rp. N\."". Cmvrteraa N In"ton uwCtenes (C*y) IMuabial Fe.S.rMuw Patent) .t ❑WMr — Spea.l Aa•aantent Da.la Sew,.Exempt Mora®Y.. ❑No Tamp.Hydrant Meta Depwll No To MeterSm 1Af %I.ea H\eh tea >� Ro �11'1 (LlillX,1,.1 eagt .__— ld FM Fe.Notation SrAue©Yee ❑No Sn A 11p1 \Y<,r Tl_,� NreMeaaon:DtY1 A ulfifti111 . Ira 'Atllyl it, /•010 not "Amu s.r Aem..• "1104. 110• (]et `.0 nc, 2c2 Slav sate. Mora MaA. `. Nem.a Caaaterwl Role 1 1 JA I; Y,rt\ 1 }I M ' a:.M No Lap.l 0.0. ❑ AXaateX ow Data In•teeaa CommaMa: ❑SeeBd task Nnwnt No owaide(M'U refta: M In aaVka eoanaery ❑ cownr�wI b Arwa ❑ Ralaaee ttan OMtrla [1-]-I B.1d"'Reea Sow RegMea Crp•a Caenaate C.b Rewaa C). Yw Np Aa.Wwank b Vac. asks,L.J PnmI Ve BreeAaB Davolp Ctnak VeWe Aa..nly ® °aedor DCVA "� Raaoeae Pre•aw.Baca Fan,Dwiae Daher (ON-(AP NbthumiK (o. % now, Qoi A01% Add,,.. 71t4 110° Ay( St An 1e1 - ReN1n, wA 1Re9lnN.A.) i 8.11 Send To: 0.0 21 Am't. c tth.t (0 1n L / (IDAr, R1Y1 t f4i i Add.•r 212E (O¢w,t1 SetNue IA'. �uHl(C 1(A 1M64-1KL Phenq�Dy "Y conhwta. •Z�I j NN sem ed Cy. Renton wow Seaae WMN SeaIM Was Cant No. Twnpary Sw�u i A pre N X Yes.AyNl Rwd,No ubMnteOmwt Yw N X Y .Euu Rerei,N. 't I.The..Eaaaq SIM Swore' Yea h. X Yet. Name Paola No. W ILt5 q Enam La.Castes.Apreaneantl YetNo X Yv.Apr.ernnn No. '+ In F.Wd_ CMapi Spetia Ut,My Cawc.on Chop• X yea,SpwM UtlMy Cone wtim Cheap.4•ed i 0yea tbo �Po Pre,Ioe•ly_— atteere Ft __MaYPM.IMaM_BMgle Fa.Ny Lora ne wm"ftelnaraoree titlYNwaoNtl aeeasrl Ca,. MYnYbw.Yallr M4�wr bn.,iaM MwYeY/ala.aY4Na.uawl..IM w.rYr.NN teraeaaaa etl NeeewN r4+on,Na..P++..^..nee.aNNIW neMtlw•er M.a•aawesewpNtl..ew ore tiN..OaaerA eaaree+a 1 A1� __ fR1YAn MAT rtpl/ IOl2e/1'�Derainow�' � a O a Apenl (Cate) CX a 1p y Ree n AWro"Apm (a.N) &W wm q a •n• ru psx MeerinaWlaocn ate•nw zu ortlOnawr CITY DF RENTpJ WATER UTILItV,200 MILL AVENUE SOUTH.RENTON,WA 98055 PHONE p9S2631 WE 4� 141a7 P 3 d � 44 A_.Y TACOMA PUBLIC UTILITIES WATER DIVISION RETURN TO: ihf a Damon BACKFLOW PREVENTION ASSEMBLY waterQualxrs°v° TEST REPORT :D rnAvy&,r .mm..WBaMmpbm Will n ,, RETURN BY: NAME: �l�J'7A.'L K N`a'� Y _ FlIE NO.: SERVICE ADDRESS:eA �b ,(,dos SLCn '3D8 LOCATION: JgWaVld-_C CROSS CONNECTION CONTROL ,FOR 6 ��T' SYYS�=�___ TYPE ASSEMBB1Oma�y�._//./J'"/qq . MANUFACTURER MODEL_ (/I9L7_.._ SIZE'_.. SERIAL 1Ng"TWOEBMTS TEST AFTER REPAIR OR CLEAN Line Pressure—___.._ _ Pressure Drop ACoss Pressure Drop Across ft.i Check YaNe_ _.— pep No.1 Check Valve.. _ _. pep Relief Valve:lpe_7d psp ReliAI VeNe Opened pap Np.1 Check ^bead ..............❑ No 1;ChKk'. biM....... akad ............. ❑ Leaked ❑Np.2 Cnepk Cbs M...............O No 2 Cbaed YpM...............❑ Leaked .................❑ Leaked ........ ... ...❑ Line Pressure.—_ NO.1 Check pb�, IgN....... No.1 Check'�c= 1M ,.. ...❑ Leaked ... ...... ...0 , ............ ....❑ No,2Cneck Closed ,,,YYY 1gM.. ..� No 2 CMc 0ghl...............❑ .. _ moake7 ..................0 Leaked ...----.......D Line Pressure _ Air Inlet Opened_ Pap Au Inlet. Ope pad Failed p cpel: ...........❑ b pPm ......:.....❑ Check Valve paid Jheck V __ pap Leaked .................0 Leaked .......... ....... Mmmmum Soparatron Yes -- No_ f IS THIS A PROPER INSTALLATION> Yes.__ __ Nor_ REMAP'(S 1 CERTIFY THE ABOVE REPORT TO BE TRUE mY Prkeed Name Pnor e,Number kmlkel Taa ft CM No. I Ampw SY ----_._ Can No e i Ti Rpae Lai By _. Deal W__.. UAW IIETURN TO WATEN 01110M N F -1 TACOMA PUBLIC UTILITIES RETURN TO. WATER DIVISION WaN.Dw w BACKFLOW PREVENTION ASSEMBLY WalerD 11001ny eceoI P D.I».t taoT TEST REPORT am u Wae kgbn sear RETURN BY' — NAME: ( L»t7✓ �C i r+� 42 5. � FILE NO.: SERVICE ADDRESS: /.�-7'�.26 `-- J/61W-A c• LOCATION: _�—R d mom--&y6 SLR / CROSS CONNECTION CONTROL FOR: r/R E q57 ./�� �Y S TYPE ASSEMSLT_ L MANUFACTURER. - V r' �!`� MOnEL—_a.L'-/.._— SIZE:- SERIAL NO _WAL TEST — TS TEST AFTER REPAIR OR CLEANING Lme Pressure ----- Frenure DroP Across Pressure Drop Across No I Check VaM_ Pad No Check Valve__. pskf Relief valve Opened Pew Relief Valve Openod _ ._-. -- - psrd No.I Check Cl,asd ...............0 No 1 Check: C eght........ ......❑ Lack eake0 .__.............❑ No.2 Check'. C IgN...............❑ No.2 Checle Clowd bghl...............0 Leaked ..................❑ Leaked ..................❑ Llrw Presauro.____ � — No,I Check- CkaW e2h1.............. No.1 Check Closed ............0 Leaked L ..................❑ i No.2 Check. ClDSW"M.. No 2Check IIBM..........'.i-G y Leaked ................ LeakeO ..................❑ Una Prwufe Ak Iniall pw Air Inlet O r psld .. FOW to OW .........❑ F lP open Check VaNe: Palo Check Valve — paid II 0 Ler„d ..................0 mwin%an BaprYbl: Vee_— ND_ IS THIS A PROPER INSTALLATION? V ale REMARKS: I CERTIFY THE ABOVE REPORT TO BE TRUEDved : t p Pn+ad N1a'm'e-��r/,, C)/;�j��j7 f Inalal Teat ft- Can No.-.�L�=�-- dM Carl No. Oa* .— Rapae TeNliv ____ ---___.____ CM No _ Dilb, PIETURN TO WATER DIVISION 1