Loading...
HomeMy WebLinkAboutWTR2702244 W-2244 Good Chevrolet f71 BEGINNING OF FILE FILE TITLE W V 7 J J F` r . i 1�- 22 �¢ Return Address: f City Clerk's Office 200 Mill Avenue South Renton,V.A 98055-2189 ie97 i e i BILL OF SALE ranperty Tax Parcel Number: Project File g: W-2244,R-22d4 A 5-2244 Street Intersection or Project Name. Ling m"k.Grady 312Ma OReference Numbers)of Documents assigned rr released: ,Auditional reference numbers am on page_ l 0 Gnntora): Cnnteefa): _, 0 I. Good Chevrolet,Inc. I. City of Renton,a Municipal Corporation ! - f4 The Glamor,a named above,for or and in considmtion of mutual benefits.hereby granta,bargain,sells and delvers to the Ft Vill I named Grantee,the following described personal nroNny now located at. ; 0 LEGAL DESCRIPTION: SEE EXHIBIT•A' By this conveyance.Grantor will onmant and defend the sale hereby made unto the Grant"against all and every person or s persons.whomsoever.lawfully claiming"to claim the same This onvc)ance%hall bind the helm exeuxam administrators and assigns forever M W ITNESS WI1E '.I beve hemumo sal the and y ear as writkn below. RL' I.aI lt)CAL FO OFACERON'LEDGMEA'T Notary Seal in he within box SIP OF WA INGTON ) 5 COUNTY OF KING ) SS 1 unify That 1 know Aveisfaclon evidence that _ I4�uYirej. 1'ytfrdel/s signed this instrument and "knox ledgell it to be hisNedtheir fore and voluntary act for the uses and purposes i announce..the instrument. o Public m d or he State of Washington 19 Notary IF, S 19 My appointment pims: 2 2Z o Dated. tp-I �-00 J 15; ra U r t Retam Antums: CITY CLERK'S OFFICE CITY OF RENTON 200 MILL AVENUE SOUTH RENTON.WA 98055-2189 Please print or npe information DOICIIMENTTITLE: EXHIRITA PROJECT NAME: GOOD CHEVROLET SPRINGSIDE OFFICE) I WATERS\STEM: 1.e09111 Sim 1J " LIX 3'' L.F.of 6 DI Water Main 16e L.F.of R" DI Water Main L.F.of War"Main L.F.of Water Main t each of 6 Gate Valves each of R Gate Valves Fire Hydrant Assemblies SANITARY SEWER SYSTEM: Loa sin 1= 613 L.F.of R PVC Server Main L.F.of Sewer Main L.F.of Sewer Main 2 each of al Diameter Manholes t each of Diameter Manholes each of Diameter Manholes STORM DRAINAGE SYSTEM: L&NM sin im _337 L.F.of 12 PVC Storm Line - - L.F.of Storm Line L.F.of Storm Line each of Storm InicCOutlet 4— each of " 1 Storm Catch Basin each of Manhole STREET IMPROVEMENTS: (Including Curb,Ounce,Sidewalk,Asphalt Pavement) Curb,Gutter,Sidewalk 619 L.F. (y Asphalt Pavement: 973 SY or RO L.F.of Width vol Q SIGNALIZATION: STREET LIGHTING: Return Address E City Clerk's Office ZIN Ilk200 Mill Avenue SouthRenton,WA 98055-21893 i1997RDN p BILL OF SALE Property Tax Parcel Nrmber: i '5, Project File a: W-2244,R-2244 R S-2244 Streetn a ter Sian or Project Name. LiM_Mere.Golly A Reference Number(sj of Documents assignad or released: Additional reference numbers an on page_ Grnntor(s): Graatee(s): 1. Good Chevrolet,Inc. 1. City of Renton,a Municipal Corporation t The Grater,as named above,for indent in eoosideration of mmual Irene lts,hereby grants.bargain.sells and delivers W Ne )" above named GnvI the following described personal property now located at } LEGAL DESCRIPTION: SEE EXHIBIT'A' r, C) l7f I rl I � By this rnnveymtt.Grantor will warrant and def:nA me sale hereby made unto the Grantee againn all and every person or pa,amI whmnsoever.lawaslly claiming or to claim the same. This conveyance shall bind the heirs,executor.administrators erW FWWIMTNE�SS rever. WHE ,1 hav hreunt seal Ne and yw as written belowDUAGPo OFACKNOWLEDGal m be wibm box STATEOFWA IINCTON ) SS COUNTY OF KINGIttnifyNat 1 ksmworhpve vtisMtory evidence Nat s n'O ia•,I �S'lur�a/l signrdthlsmstnmicil nd 6etap R•��,'�x acknowledged it to be hisllsernheir free and voluntary sell for the uses and purposes -,0 Y mentioned in the imuumenl. wi b'T aa�' w sl.x d e�•;do-` out Public in d or he State of Washington k FC 7 Notary(Prin s••.4F IYAl.UTN'exr� My appointment vices: p wm,„s•ss" Dated. J 9t.: dw 3 t 5 n� Y ell A� LEGAL DESCRIPTION � PMm A: (Must be st—Ped by a P.E.o,L.S.) LOTS 1 THOUGH 12: BLOCK 27; C.O.NRLMNeS EMHNGTON GARDENS ADDITION TO THE CITY OF SEATTLE DIM9ON No. 1: AO=C G TO ME nAT THGEOT RECORDED N AT2.VHI[17 M PLATS PAR TA; RECORDS W TONG COUNTY. WASHNGTON. EXCEPT MAT PORTION THM,p CONVEYED TO ME STATE DE WASNINORN »�MY STAR 19GHWAY PURPOSM BY O,G COUNTY RECORDED NO. WIDENER WIN MAT PORTION W VACATED ALLEY ADJRW OG AS VACATED TIN BY E CITY OF MACH ORDNANCE NO. PARCEL B: LOTS SO TIN)110N 57; 9LOX 2T. CO.HIWIM'S EMJ OYGN GARDENS ADDITIONTO ME OW W YATTLE 01MBON NO t: ACCORDING TO ME IN. NOMOT RECORDED N ADIVME 15 W 1L,n: PAR 14.RECORDS OF KING CONTY, WABN,,GTO, ERRPT MAY PORTION NMOI`CONAVTD TO THE STAR W WAUNROTON TOR PRNMY STAR HIGHWAY PURPOSES.BY I NG CONTY RECOIDIMC NCI. N29TD4 TOGETHER WM MAT PORTION W VAGRD ALLEY AW,,,,C AN,MAT PORTION W VACATED S.W. 12M SIM, ADDNND AS VACATED BY ME CITY W RENTON GDNANGE NO. PARCEL C. LOTS I THRCIIGR 12; AG,51 MRGIGN 62: BLDO(A: C.D.N,L,AKS EARLINGTON n W SEATTLE Ol"ON No. 1:: ACCORDING MS PLAY ION To ME E TIQCW RE URI CORDED N M] [17 W PLAYS: PAR 24.RECORDS W KING CONTY.WASHPICTVN. EXCEPT MAT PORTION W LOTS 12 AND$I CUNV[YLD TO ME STATE W WASHNNCM N FOR PRNMY STALE HIGHWAY PIMpSES,BY NNG C"W RECORDING NO. 6428422: TOGEWER WTH MAT PORTION W VACATED ALLEY IDJGHMRC AS VACATE, BY THE CITY Cr BENTON ORDNANCE 1IO.25E9: TOGETHER WM THAT POIllSm W VACAR C SW 12M STREET AND MAT PORTION OF VACATED St ISM STREET AND MAT PORYDN W VACATED MAPLE AKHUE SW �AS VACATED BY BE CITY W RENYDN ORDNANCE W. _ PARCEL 0: LOTS 1 INRGTGH 12: AND 14 ACED IS AND A>AND H: BLOCK 22 C.D. M LAMS[ARLINGTON GARDENS ADDITION TO ME CITY W SEATTLE DIM9ON NO, 1: ACCORDING TO MC nAT MEREW REDOIpED N ,LW 17 W PLAYS, PAGE)A: RECORDS CIA IGD COONTY. WAS,,,,,R, EXCEPT MAT"ION W LOTS 12 AND 51 DOI. TO THE STATE W Q' WASHING" TOR PNMMY STAR HIGHWAY NN ,L RY I,NG COINTY C) RECORDING NO. SLRECORDING9 AND RECORDING MO.SM1244. v WORMER NM MAT PORTION W VACATED SW ION STREET AND MA, PORTION W VACATED MARE AVENUE SW. ADAPND AS VACATED BY ME W4 Ott W RENTGN ORDNANCE No. G o Q� 1�1 H I Wr'BS EHy .7_ I_ F �+ r of i I l Return Address CITY CLERK'S OFFICE CITY OF RENTON 200 MILL AVENUE SOUTH RENTON,WA 98033-2189 I j Please prim or type information � DOCUMENT TITLE: EXHIBITA j .. PROJECT NLME: GOOD CHEVROLET i SPRMGSIDICE E OFF / WATER SYSTEM: Lain Siu IXPs 32 L.F.of 6 DI Water Main 30 L F.of 8" DI Water Main L.F.of Water Main L.F.of Water Main I each of 6 Gate Valves each of 8 Gate Valves " Fire Hydrant Assemblies j SANITARY SEWER SY STEM: LLUOI Sits I= { 613 L.F.of a PVC Sewer Main L.F.of Sewer Main k *t L.F.of Sewer Main �fn 2 cub of 48 " Diameter Manholes Q� each of Diameter Manholes euh of Diameter Manholes i G STORM DRAINAGE SYSTEM: LcUth Sim I= 337 L.F.of 12 PVC_ Storm Line L.F.of Storm Line i L.F.of Storm Line i each of Storm Inlet/Outlet 4_ each of " I Storm Catch Basin .� each of Manhole STREET IMPROVEMENTS: (Including Curb,Gutter,Sidewalk,Asphalt Pavement) Curb,Gutter,Sidewalk---AU L.F. Asphalt Pavement: 973 SY or So L.F.of 2' Width SIGNALIZATION: , STREET LIGHTING: r.� <1U r '' i �f xnh,(f e a • ---���III tr, CITY OF RENTON PLANNING,BUILDING/PUBLIC WORKS DEPARTMENT FINAL COST DATA AND INVENTORY ` NAME OF PROJECT WTR W WP- Good Chevrolet TRO- SWP- TED- Per the request of the City of Renton,the following information is furnished concerning final costs for improvements installed and turned over to the City for the above referenced project. WA_TF fu CONeTRIICTIGN COSTS Length .rue Type L.F.of 6'. pip _ WATERMAIN L.F.of It TITP WATERMAIN WATERMAIN L.F.of WATERMAIN L.F.of __ EACH Of 6 GATE VALVES EACH of GATE VALVES EACH of GATE VALVES EACH of FIRE HYDRANT ASSEMBLIES f (Cm of Fire Hydrants mutt be toted separately) f 1 O.e-AO (laclude Engineering and Sala Tax if applicdble f '- 1..,, TOTAL COST FORWATER SYSTEM $ �10,830 •�IT•RV CFWFR fytTFM cTOfLM DRAINAGE cycTFM; `Lengh Size Type Length Sin Tip STORM LINE .of B" PVC SEWER MAIN 337 L.F.of 12" PVC 613 L.F _ STORM LINE ! —� SEWER MAIN L.F.of 'a _ L.F of L.F. f — STORM LINE L.F.of SEWER MAIN EA of STORM INLETCATC OASIN i 2 EA Of 48" UUM k MANHOLES �_ _— �— ��CATCNBASIN EA of DIAMETER MANHOLES EA of EA of STORM CATCHBASIN tkekdky E%OResing ead SWs Tu $ 17,3 27 (Inelud j En{userirq W SWt Tu if"Okable) f appllcabk) S TOTAL COST FOR SANITARY SEWER SYSTEM f 17,327 TOTAL COST FOR STORM DRAINAGE B, SYSTEM STREET IMPROvEtIENTS: (Imluding Curb.Gutter,Sidewalk,Asphalt Pavemene) Cub.Cuter,Sidewalk: 619 •L.F. $7,428 t 80 L.F. of 2' _ Width f 13,476 s��y Aspluh Pavement: 973 Sy or •"f ,.,zs•_ I SIGNALIZA7TON: (including Erg.Design Casts,City Permit Feee,WA St 5a1et Tu) � I r STREET LIGHTING: (lodwhog Eng.Design Coos,City Permit Fees.WA St Sales Tat) 1 ,i vt • T: k t It 1, aOf POW a3a 20 CD 1 g signatory tome Wtone { rvz . .'. ' (OIGNA ., fr.p A 1W.WCOST ATI.DOClbh (W ownu of subdoce velophenti ` +f. t 'Fy< 4 , � i+'!�M'Rsauww=......-__- _ ..�.�++ '•^ �b�a ...�. ..._ .. ..rn+^u�wMM•wISW� Return Address: _ City Clerk's Office Tut" 200 Mill Avenue SouthRenton,WA 98055-2189 9 1 19 97 pie c(? Title: UTILITIES EASEMENT Property Tax Parcel Number:33y Project File#: W-2244,R-2244,S2244 Sims Intersection or Project Name:Lind,Maple,GrWy,Illh @ I no _ Reference Number(s)of Documents assigned or released: Additional reference numbers we on page Graator(s): Graotee(s): I. Good Chevrolet,Inc. I. City of Renton,a Municipal Co-soration 2. TM Grantor,u named abova for,or and in consideration of mutual bencfes,hereby grants,bargain sells and ddiveu to Ne above earned Grantee,the following deseritwd personal property now located at Additional legal is on page 5 of document (A1arrWud/gdhacr00oaaNST9eaere) LEGAL DESCRIPTION: m An easement 15 feel in width over,under,across and through a portion of Lots 11, 12,51 and 52,Block f+� 27,lots 10 and 11,Block 26,C.D.Hillman's Earlington Gardens Addition No.1,according to the plat 0 thereof recorded in Volume 17 of Plats,page 74,Records of King County,Washington,and of the C vacated alley and vacated right-of-way of S.W. 12th Street adjaceir to and which attached to said lots by operation of law. AND EXCEPT that portion thereof conveyed to King County fur toad by deeds recorded undee C'a Recording Number 6407767 and 6407768. �Y I Fa a r l a j CO3I 1 EX TAX NOT REQUIRED ng Division Do" t 1 f � Mat said Grantors),(wand in consideration of mutual benefits,do by these presents,grant,bargain,sell,convey, and warrants unto the said Grantee,its successors and assigns,an easement for public utilities(including water, ! wastewater,and surface water)with necessary appurtenances over,under,through,across and upon the following j described property(the right-of-way)in king County,Washington,more particularly described on page 1. (or if I{ full legal is not on page I..Exhibit B.) For the purpose of constructing,reconstructing,installing,repairing,replacing,enlarging,operating and maintaining utilities and utility pipelines,including,but not limited to,water,sewer and storm drainage lines, together with the right of ingress and egress thereto without prior institution of any suit or proceedings of law and without incurring any legal obligation or liability therefor. Following the initial construction of its facilities, Grantee may from time to time construct such additional facilities as it may require. 'fnis easement is granted subject to the following terms and conditions. 1. The Gunner shall,upon completion of an)work within the property covered by the easement,restore the surface of the casement.and my private improvements disturbed or destroyed during execution of the work,as rearly w practicable to the condition they were in immediately before commencement of the work or entry by the Grantee. 1. Grantor shill retain the right to use the surface of the easement m long a such use does not interfere with the easement - rights granted in the Grantee. Grantor shall not,however,have We right to. a. Erector maintain my bu'Idtngs orstmcsurs within the easement;or b. Plant owes,shmbs or vegetation having deep root patterns which may cause damage to or interfere with the utilities to be placed within the casement by the Grantee;a c. Develop,landscape or beautify the casement arcs in any way which would unreasonably increase the cost.o.the Grmmc or restoring the eaxment area and my private improvements lhemin. d. Dig,tunnel,or perfamt other formsofconstmetion activities on the progeny which would disturb the compaction or unearth Granice's facilities on the rightof-way,or endanger the lateral support facilities e Blan within ffUen(15)feet of the nghtof-way. This easement shall con with the Ind described herein,and shall be binding upon the parties,their heirs,successor in interest and assigns. Grantors covenant that they are the lawful owners of the above properties and that they have a good and lawful right to execute this agreement. bh m By thi;conveyance,Grantor will warrant and defend the sale hereby made unto the Grantee against all and rvery Z7 person or persons,whomsoever,lawfully claiming or to claim the same. This conveyance shall bind the heirs, 0 executors,administrators and assigns forever. s / Ju ul IN WITNESS WHEREOF,said grantor has caused this instrument be exnuted Nu aJday of1957 y� t i'. [Y � r v 41 Y. Y f F. A TI ' M4 rF EXHIBIT"A" LEGAL DESCRIPTION PMCa N (Mml be su ped by a P.H.oR L.S.) 1015 1 TENOUON 15; KOON 37; CO.MAL MANS EMBJNOTON GMDOO ADOTdI 10 THE OTY OF SEATT E DOW"NO 1; ACCOMM4 TO THE MAT TEWEV MCORM IN VD.VYE 17 OF PLAYS; PAOC E1; RECORDS OF DMNO COUNTY, WASMNDTDII. CXMPT MAT MOON TRMOF CO'1SYED TO THE STATE OF WAAWOTON FOR PRaJMY STATE M>4"Y PURPOSES BY NwG CONTY MEONOED NO SASBTOL TOC TO WIN MAT PORTION O VACATED ALLEY ADJQMG AS 'ACATED BY THE OTY O BENTON OMMAMM N0, PARCEL R LOTS SO Nft U 57; ft" ST; CO. MaJNMS EARUNDTOI CMOENS i '- AD01OR TO TIE OTT O MATTE OMSON NO 1; ACCOIONG TO ME MAT THEREOF RECORDED R WLVMC 17 O PLATS PAGE 71.KCORDS OF '! DING CONTY.WASNINGTON. EXCEPT MAT PORTION MEMO THE TO T STATE OF WASMWOTON FOR PRM EDU ARY STATE M)MWAY PURPOSES.BY MNG NTY RECORDING NE. I' : 5429700; 1 TOOETI01 WM MAT"I"OR OFVACATED ALLEY ADJOEMG AND MAT MOEN OF VACATED SW 1IM STREET ADJDNMW AS VACATED BY ME 'Ic OFF OF MORON O ANM ND PARCEL C LOTS 1 TMNIUON IS; AND 51 MNDUDN BL BLOM M; C.D.M A S a' EARIRGTON CAREENS MOTION TO THE OTT O SEATTE OMSON NO 1: ACCOIIORO TOM KAT THEREOF RECORDED IN VOLUME 17 OF PLATS; PACE 71.KEOROS O XNG MMTY. WASRNOTOI. EDCEPT MAT PORTION O LOTS 11 AND 51 CONVEYED TOM STATE O ' YMSMRGTON FOR PRIMARY STATE MKMWAY PUMOSM BY XRG COUNTY "1 YOOET!R WM MAT PMPQM OF VACATED ALLEY ADJONNNG AS VACATED BY M OTY OF WNTON OIONANCE NO SUB: TOETNEP MM MAT POnOR O VACATED SW 12M STREET AND MAT POMn011 OF VACATED SW. ISM STREET AND MAT PER N O VACATED MAPLE AVENUE S.W ADJONWNO AS VACATED BY M OTY O PENTON OroMAMM ND. _��� PM D. LOTS 1 1MR0001 12; AND 11 AND 15 AND 17 AND M; KOM St C.D. E.. MJJJMS EARLINOPM GAPOONS AOOiT Ml TOM OTY O SEAME OMSON M 1; ACCORDING TO ME PLAT NEW-OF REFORMED R VOLUME 17 O PLATS; PACE 71; RECORDS O XRC COONTY.WA31aMTOM. EXCEPT MAT PORTION O LOTS 15 ANO 51 CONVEYED TO M STATE O MASMNGTON FOR PRMMY STATE MONRAY PMPO$A BY DING comw KCORDMC NO. 511671E AND RECORDRG NO, SM11/O.STREET A AND A CI PORTION OF VACATED MAPLE AKMUE SW IDJM"AS VACATED BY M V4 Ott O RE NTON OROMMCE NO. G ,•f6 m O � I cvElu w , i • ,_ r is eC e s' Y t to 0y a M� 1 w Return Address: City Clerk's face 200 Mill Avenue South Renton,WA 98055-21 g9 BILL OF SALE Property Tag Parcel Number: Project File e: W-2244,R-2244 R S-2244 Street Intersection or Project Name: lar J.M w,oredv A❑dta um x Reterence Num%Ws)of Documents assigned or released: Additional reference number ve on page Grantor(sy Graatae(s): 1. Good Chevrolet,Inc. I. City of Renton,a Municipal Corporation Th.Greater,as named above,for m and in comidenitiun of mutual benenta.hareby gtmn.bargain sells and detivm w the above named Granter,the following described personal prepem now located at LEGAL DESCRIPTION SEE EXHIBIT'A' A , By this conveyance-Grantor will warrant and defend the sale hemb%made umo the Ul mre agaimt all and evm Panchen person&whomwever.lawfully claiming orto claim the same Thrs com<)ance shall bird Ute help,evecurors edmiNmateo and u usi era fortrtt. N sYI' ESS WHE .I have hereunto mi the and year o.Pine;below tA'Dtt7DL'ALF �A OFACENOWLEDGMEW r ,^ ' t Nomy Said m be within boa STATE OF W AS41NGTON ) COLTTY OF KNG ) SS 1 I mtih Mrs 1 know a ve vnyhcron evidmca that_ Hps�n-{ `cr•sH•rs ai - �Y _ t fr,then instrument and rknowledgM h ro be histserthen tree and raiumm act for 4,uses and pumosea mentioned in the immithem. j 'ot Public in d r the State of W'aMingto?— --- r Note,(Prier - My appointment Aires: 7-yZ Dated. W J Papal J az I Rerarn 4&*ess' —1 CITY CLERK'S OFFICE CITY OF RENTON 200 MILL AVENUE SOUTH RENTON,WA 98055-2189 v Please print or qpc information DOCUMENT TITLE: EXHIBIT PROJECT NAME: GOOD CHEVROLET SPRINGSIDE OFFICE' WATERSYSTEM: Ltu lh Site 14X 31 L.F.of _ 6 DI V •ter Main 36ILL.F.of A" DI Water Main L.F.of _ Water Main L.F.of _ Water Main I each of 6 Gate Valves each of __B Gave Valves Fire Hvdmt Assemblies SANITARY SEWER SYSTEM: LcitO Sim 149 613 L.F.of 8 PVC Sewer Main L.F.of Sewer Main L.F.of _._ Se..er Main 2 each of 68 Diarrmter Manholes each of _= Diameter Manholes each of Diatneter Manholes STORM DRAINAGE SYSTEM: Lemo Sin L'rs 337 L.F.of 12 PVC Storm Law L.F.of _ Storm Line L.F.of Storm Line each of Storm Inles'Outlet 4_ each of 1 Storm Catch Basin each of __ Manhole STREET IMPROVEMENTS: (Inclaci ft Curb.Gutter.Sidewalk,Asphalt Pavement Curb,Galtar.Sidewalk 6I9 L.F. Aephak Pavement oft _Sy m 20 L.F.of 2' Width SIGNALRATNNM: STREET LIGi TMi I , 5 Y , r .4 H R,Ma r i I EXHIBIT"A" LEGAL DESCRIPTION PNICQ A: (Must be E peO by P P.E.or L.S.) - LOTS 1 TMOuGH 11 KOCR sT. C.O.MRWM'S tAw"G1M GARDENS ADDITION TO THE all W SEATTE OLOON M. 1: ACCOMONG TO Mt RAT MIKW NECORM M VOLUME IT OF ARTS PACE TA: MCODS Of RING COUNT'. MASIMGTM. EXCEPT THAT"710H rMalr COIIV[TED M THE STATE W ACAS MDTM MR PRWARY STATE s RAY PURPOSES.BY KRD CUMTY RECORDED MO SMtITOS 100END IN MAT PORTION OF VACATED ALLEY ADJOPOG AS VACATED by THE 0, 0/PENTON ORDNANCE M. PARCEL M LOTS SO MMUM$7. K" ET; CD. MRAMM'S EARLPIOTM EARpEMS ADGITON TO THE CM OFZ.ATLE CMSOI NO 1: ACCORO M NG TO T PLAT THEREW MCOMED M V kbg 17 OF PLATS; PAGE TJ,MCMOS W 'Na C0u%W. MAMwOTON. EXCEPT MAT PORT M THO OF COMv[VM TO ME STATE W MACIMOTOM rM PRMARY STATE I WAY PDIMUS.BY MARC COUNT'RICOMfMRC MD SA 100, IOGENSA VIM TNAT PORMM W VACATED MACY ADJDMING AMD MAT PDIMM OI VACATED Sa ItM&TRW ADJOIMW K VACATED By Mt aw Or MM1ON w"AM E ND PARCEL 0 LOTS 1 TMMSKM 12 AM SI TMOOM It BLOC( M; C.O.MILMANY EARLM WM OMOMS ADDIMON TO W CT W f ATTLE DMIM RED ACCAl10M0 M THE RAT THEREOF MCOROM M Vp.O1[ 17 Or PAYS, PACE TA MCOMS Of INC COMTY. MAAMOTOM. EXCEPT MAT POISON Or LOTS 12 AND St COMYEM TO THE STATE Or MASMACTOM rp1 PRMARY STATE MIOHMAY PMPOBLS, By ma COIMT MCOMOIO NO SatSa]t. TOCEMER VAN MAT PONT A OF VACATED MAZY ADJOMMG AS VACATED lY 114E Ott or mm 00"MNtt RID SST: TDOCINM MM MAT PORTION W VACATED SR 12M STRUT AJD TUT poft O W VACATED Sa ISM STRUT ANO MAT MTKP,W VACATED MARE AVO"Sa ANJOND AS VACATED by ME CITY W MMTYM ORDNANCE M. PARCEL O LOTS 11NRWM t; AMD 14 AID 1S AMD At MHO M: BLOCK SZ Co. MLLMMIS tAR%ft GM10MS JERRN 11 10 US OW W SEATTE ONION MC 1: ACCORWW TO ME PLAT TAUKOF PZCOMED 0 VOLIMR 17 W RATS PACE TM: BECOME W ONO CDLMT'.MAMMOTOM EXCEPT MAT PORNN W LOTS 12 MD 21 CMWM TO lK STAR W wMmRQ1YM rM PMMARY STAYS MMVMY RMMSM lY MNG MUTT IOCMIYM M0. SIIITII AM RECpo"S MQ SMISK TQOENM MM MAT ROTOR W VACATED Sa 17M STRUT AND MAT PM%QM W VACATED MAPLE ANMA Sa AOJO"AS VACAI[O BY*9 CRY W MNIER MIMAMCE MO •., Lev � twAi 4 Y J i a i s a, 1 - CITY OF RENTON PLANNING, BUILDING/PUBLIC WORKS DEPARTMENT FINAL COST DATA AND INVENTORY NAME OF PROJECT WTR- WWP Good Chevrolet SWP. TRO- 1 TED- Per the request of the City of Renton,the following information is furnished concerning final costs for improvements installed and turned over to the City for the above refdrenced pruject. WATER SYSTEM rQNSTRITCTION COSTS, Length Sue Type __Jtj L.F.of 6„ DIP WATERMAIN 366 L.F.of Rx nTD WATERMAIN _ L.F.of WATERMAIN L.I.of WATeRMAIN I EACH or ��_ ' GATE VALVES EACH of GATE VALVES EACHof GATE VALVES EACH of FIRE HYDRANT ASSEMBLIES s -- (Cou of Fin Hydnms must he listed separately) S I D-R 3 n (Include Engineering and Sala Tax if applicable g TOTAL COST FORWATER SYSTEM SANITARY SEWER SYSTEM STORM D AINAGF SYSTFM- Lengm Sue TYPI Length Size Type 513 L.F.of 6" PVC SEWER MAIN 337 L.F.of 121, PVC STORM LINE L.F.of SEWER MAN L.F.of _ STORM LINE L.F.of -- SEWER MAIN -- L.F.of _ ' STORM LINE 2 EAR( qgx A E RMANHOLES 4_ EA or _ ' STORM INLETIOVILET EA of DIAMETER MANHOLES EA of _ ' STORM CATCHBASN (IeeaMiva leaunerW ea�i�u EA of STORM CATCHBASIN d Wk") S 17.327 (Imkdhy llryinesrk4�7u TOTAL COST FOR SANITARY SEWER SYSTEM 3 17.327 if Wickbb) S TOE FOR STORM DRAINAGE S 81055 STREET IMPROVEMENTS: (Including Curb,Gwwr,Sidewalk,Asphalt Pavement) Curb,Outset.Sidewalk! 619 L.F. $7,418 Atpllah Pavemem: 973 Sy or 80_L,F. of 2' Width s13,476 SIGNALIZATION: (Including EN.Design Corn,City Permit Fees,WA$I Saks Tax) STREET LIGHTING: (Joeludiry EW Design Costs.City persist Fese.WA St Saks Tax) d of polls S pbeee R (s1aHA / 47 feraulCWTDA77.tJOC14, nary once be vadetrla dl agent q or owner of SWJem daveloppm) i J t. 1 Return Address; City Clerk's Office 200 Mill Avenue South Renton,WA 98055-2199 Title: UTILITIES EASEMENT Property Tax Parcel Number.33y F.-,; Filea: W 2244,R-2244,52244 Street Intersection or Project Name:Lind,Malik,Grady,12th a.13th Retaseate Namber(s)of Documents assigned or released: Additional reference numbers are on pop__. Graator(s): Graotee(s): 1. Good Chevrolet,Inc. I. City of Raton,a Municipal Corporation 2. Taa Crantior,a caned above,for,or and in consideration of mutual bene ns,bereby grants,bargain,sells and delivers to the above maned Grantee.the following dcwnbed penonal property now located ai Additional legal is on page 5 of document. (ADWesJanrd legal dearripaos.NL'STgo hen.) t I LEGAL DESCRIPTION: An easement 15 feet in width over,under,across and through a portion of Lots 11, 12,51 and 52,Block 27,Lots 10 and 11,Block 26.C.D.Hillmans Earlington Gardens Addition No. 1,according to the plat thereof recorded in Volume 17 of Plats,page 74,Records of King County,Washington,and of the vacated alley and vacated rightrof-way of S.W. 12th Street adjacent to and which attached to said lots by operation of law. AND EXCEPT that portion thereof conveyed to King County for road by deeds recorded under Recording Number 6407767 and 6407768. = i 1 ,r C I gaR 1 �J That said Grantor(s),for wW in wnsider bw of mutual benefits,do by these presents,grant,bargain,sell,convey, and warrants unto the said Grantee,its succe oars and tssigns,an casement for public utilities(including water, wastewater,and surface water)with necessary appurtenances over,under,through,across and upon the following described property(the righ'of way)in King County,Washington,more panicularly described on page I. (or if full legal is not on page I—Exhibit B.) For the purpose ofconstrucling,reconstructing,installing,repairing,replacing,enlarging,operating and maintaining utilities and utility pipelines,including,but not limited to,water,sewer and storm drainage lines, together with the right of ingress and egress thereto without prior institution of any suit or proceedings of law and without incurring any legal obligation or liability therefor. Following the initial construction of its facilities, Grantee may from time to time construct such additional facilities as it may require. This easement is granted subject to the following terms and conditions: 1. The Grantee shall,upon completion of any work within the property covered by the Cavemen[restore the surface of the easement,and any private improvements disturbed or destroyed during"motion of the work,as nearly as pvmrcable to the condition they were in immediately beftne commencement of the woe or carry by the Grantee. 2. Grantor shalI retain the right to use the surface of the Cavemen[as long"such use does not interfere with the easement rights granted to the Grant". Grantor shall not,however,have the right to. a Erect or maintain my buildings in structures within the casement.or In Plant trees,shrubs or vegetation having deep root panems which may cause damage to or interfere with the utilities b be placed within the easement by the Grantee;or c Develop,landscape or beautify the easement area in my way which would unreasonably increase the costs to the Grantee of«poring the moment area and any private Imorovements therein. it Dig,tunnel,or perform other forms of constnation activities on the property which would disturb the compaction in uneuth Granter's facilities on the right-of-way,or endanger the lateral support facilities. e. Blaa within fifteen(IS)feet of the sight-o6way. This casement shall run with the land described herein,and shall be binding upon the parties,their heirs,successors in interest and assigns. Grantors covenant that they are the lawful owners of the above properties and that they have a good and lawful right to execute this agreement. 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,administration and assigns forever. IN WITNESS WHEREOF,said grantor has caused this instrument to be exeewed this a� Sarna 417 _day of_19_ i Paac 2 it FT 3 It. 1 .rr� Ly A � 4 % 444n 1 1 �a 4 OR DISTRIBUTION TO: Ofwater Utility ® Building DiYlslon rr��11�� o IYI wastewater Utility tJ Public Works Consir IuNmaur L�Ski Surface Water Utility ® Fire Prerenilon �J Maintenance Servleey 't're nipor�utloon�Syymmsn I ulect. yp eat44.AVq :uauon: e uecned pity It itno Copley of: 110 PERMIT BILLS OF SALE U;n RECEIPT COST DATA INVENTORY :A LETTER OF SPECIAL BILLING EASEMENT(S) ' ® STUB SERVICE AGREEMENT C COPYOFAS•BUILT i - rI PRECON NOTES ' jPRECON ATTENDEES ® — IFN DRAINAGE REPORT '- '© h1EMO-WATER BREAR'DOWN MAP WITH NEW MAINS AND VALVES .. 'Ry 0.1-HER ^Prom: �a 1 f „ a I email ArTR 21224 ✓ t+ 000d ('4� . p r v655,, Q Te-0 -take" glglq& i 9jlOj Qb Amber Construction on site to begin installation of the 12"ADS seam drain on the can side of the property CBN I SA to CBN 15, CBN15 to CBN6 and 1001f of 12"ADS per line and grade as staked. 'l'yMar Day-Fri DateB/28/96 Weather-Pnly cldy Temp-60-78 Precip-None - Clements Construction called me to discuss a change in the storm lines due to c nflict with the High Pressure Gas Main and the telephone fibre optics conduits. 1 told him it looked like the most logical way around the problem. Day-Fri Date-9/29/96 Weather-Clear Temp-S64ift Precip-None Amber installed CB N4(Type 1)and CB N3 to revised invest elevation. Revision includes reversing flow Brit direction.CBNI to CB42,CBN2 to CB"to the cast on 12th Street. This is necessary to avoid conflicts with the existing underground utilities on SW 12th St.(south side of street). This eliminates the used for 160 1f of 12"pipe between CBMI and the existing CB at the SW corner of 12th and Lind A� (Sec plan sheet C-3) Day-Fri Date8/30/96 Weather-Clear Temp-53-77 limip-None Amber connruniou imitated a red CBNI and CBN2 with 24 If of 12 ADS storm drain across SW 12th St. Also initialled 160 If of 12"between CBN2 and CB44 on the north side of 12th st.per revision(a change in the direction of flow) Trench back0' s gravel harrow. Day-Fri Date-9/4/96 Weather-Cloudy Temp-SS-70 Precip-Occ Shan Archer Construction began installation of the new 8"water main. Located the 12"stub off of Lind Ave +Sm. 100+00 Lt, The 12"is further out into SW 12th St than indicated on the plan(Sh C-9). Mercian there is no need for bend(s). the new 8"begins immediatcy off of the 12"(10 n separation for blowaff and future tie-in)5 it It of centerlim SW 12th imtalled 8"m Sta 2,10 by end of shift. Polywrapped as required,3 n of rover,gravel borrow for trench backfnll. Day-Fri Date-9/5/96 Weather-Cloudy Temp-52.70 Prie ip-None I Amber maall3d nether 100 IN of 8"DI water main on SW 12th St today. We may have to revise the tie- in detail to the IT'main on Maple Av SW,because the 6"valve to off of a 6'x 12"tee and and 8" reducer canna be installed on a 6-valve as called for on the plan Archer will pothole the existing 12" ntam tomorrow,to look at the 6"connection. j Day-Fri Dam-9/06/96 Weather-Clear Temp-53-72 Precip-Now �I Archer Corot potholed the existing 12"main on Maple Ave. There exists a 12"x 6"tee,Wes would have to cut in a 12"x 8"la or bring the new 8"DI directly into a 12"x 8"saddle up&x'ah c. I asked Archer to hot up an 8"GV(M;) They will use Spar. Day-Moe Daec-9/09/96 Weather-PIIyC1dy Temp-531e Precip-None i Archer pressure rated 450 Vol new 8"DI water mom this date. It failed to hold pressure aner 1-112 hours. They will retest tomorrow AM. Day-Tun Date-9/10196 Weather-PIlyCldy Temp-53-72 Precip-Nose Archer sucessfully pressure tested 450 If of 10"DI water main on SW 121h St. Requested chlorination for tomorrow AM. Duration. 2 hours 450 1 f.8"DIP Loss 3 psi Test passed Day-Tun Datc•9/11/96 Weather-Overcast Temp- Preelp- Tom Main-"Took two water samples for Man Burge(Good Cher')" Day-Tun Date-9/12/96 Weather-Cldy Temp-53-72 Preclp-None e"water main on SW 12th St,contractor(Archer)flushed the clonnated line into the nearest available sewer Mill. tom Main obtained two(2)water samples at 9.45 this AM for purit). 1 submitted a request to schedule a tic-in and cut&cap existing 6"main. Tic-in is scheduled for Tuesday AM,9-17-96. Rom, 30b 3 - 14yn4eAn Goy AL Mary I5'"L' I 09 13A6 FRI,17'.29 Fy L.7.1 S�1 IAC L4UCKS TESTISG lJueka Teating LDooratones,Inc. 9S0 S.,NRrnlY gunk.WW iB1pR � 9�0$.HRlMY Sank.WA�T08 WATER BACTERIOLOGICAL ANALYSIS WATER BACTERIOLOGICAL ANALYSIS SIl1REW1ECTION-READ 04STRUCTONSON BACK OF GOLDENROD COPY SWRECOIMK .REAOINMUGTIONSONBACROFGOLDFNAODC,:v ■MrIKlblk NY.I NR.Rr,MRTPIP WW�kF�FF6 RMMRYOReIkMMMMRM.rIIOk RNI kR IRFFR'TFR_ wEcma CTFD KCot1RCfl. COIMT'NAYE ORTE COLLECTED Tod Cow D COtRIIr NiyF r7lm k. - frMOPST'STEY R FUMC Mnak COMPLETE TYPE OF SrSTFM r HRc X"MK amoum /�V( -- gv�M101M aBp�Opyp R'olvnuw LD.Ne. 5 ( t VB " 0Iwmoua 10.Ne. / ��� \J RaTEDF mrtr ,nt-Z24y Vim$-I>�� wk[OP STSTTD. � t rEDRCIA'NTON.FIua EN.TE No. IDnTIDN SNwE KLLECI® TEL N0. �.V1• IZTH ST. wr • � � �.vJ. �2THC g0. Mvl I H EYp1R1GT Ey aTNnE coutcrev B.:TN.F.I sraTat oR.oywE:lkF.kl � aartt ITr.MTsT sysm o .Inearx R.F.T —' Toth MAi I,5 I R4`t SL E a 'f SOIRCEIVPE aRDUNDWAM ROERKW"CERRRUENCT salRu GRotw TTATTm you snF EpIU D aaIFRDE Ow"a`eu n O new s.""D (] .�F TTON �°re`.tE ❑Wv paZ CVRNG CKPICIIASED.JQ TTDN . TT6,�gw rJ N.Ik,YM. bGkq app TOIPM1R M.M _1�`( hG• 1C.tzY_ETn�I- l� I•(^y �.4f. C,:,1T�' f� 1.1 'DEAT. 'C1 MILL AyE. So. Zm MILL AUE tnr�. TYPE DELWIEIR.aMalAk waawnT rYNOP SAYREIaks.W.kk w.yF.q J pROUMYtNE('.YMRR ❑CI`rIw11M1RiW',�TW_FMI ❑ DMktER ❑OrNNkk01MR?+1'�tII�FMI I Rr,r I IR.�tFEvpkr_ IRIFTARRWOFIN wok.mlNn-PwRli Ir• P OFk / I OFY I SO IT (y'•�RNw UITCE WATER aNwE®m nT.kfsakk MWSUACE WATER a fajYT I TkIck ]urlWCaOTWC+Ia+.MMME ��++UII EAmorw. MVCd6rIluCT -4qr Ras uJ �Fw lQ—OTIR3t tSaeMoTTIEII IEptlIY1 RAR use OFRT ORRFIRNG TTUTERROBUTE nWa ya[oRET oRyFRaFG WRIER RESTI,n C vI15•TT$EI(4ORY.fPbI1M Flwnl 5�71SF ❑UNSNMFACTOW faYmlk PAIN a OSAR�RFA Y�r REPERT E.Cmw LOW. CWIbnW WR11PE{AET� I^�Lcw PIMFm r' tc&F rfi� 8 ig 0R-. s RO tlN a Ab U R O.wwN FO... 0T UIEDR-OWNEIR.Ts `OTmtAlMTWfXVLTa romeouFank A no. ECW nmlN ror4 CRYOIw�mm�+ E.CDUp, Rm FirUA s _nmw IUATE tOurrt_n.+ EEfj000uplk_nm• PUTECDuw w WOTMINSAI^EAEDWEO .WDTIER&M EREOUMD G ENOTTEMDSECAUSE. TTSTk TFaEEEEGUSE EyQQIREIgt MIap EECAUSC TE❑STUNaJITARIETkUylS. }O{I NeRly WTI.FW ❑TMnaM G"�v Wnker �j RC I�1mIkY.4m a TIMT C.w r VmTLAk MII fff� . ❑ ❑ESFaFNIF TLS: hw ClanF SEE REVERSE SIDE OF GREEN CO"FOR(DIPtANN}TDII OF RESUETS ME REVERSE SIDE OF GREEN COPY FOR EXft AnON OF RESULTS W IRI.ROMR WRT.IWdnpaO WNO IYtWRTk WYI TR{IpMD T `?1140C1? Gl l2-�f(o dtrl40oLY z2 ��.z:u I>W WIII R WSMTaIw tkTlwwko weR.TRRY. 113 RFNkF wN J 1 LnENn TWrNng Wows WrNE.Inc. 940 S.NRr S a"w WA 99TD8 WATER BACTERIOLOGICAL ANALYSIS SMOU COLLECTION-READ INSTRULT ONS ON BACK OF GOLDENROD COPv rNawWRaa nN EaNswaA.aAalAwwM Maa• I. ATE LOI KcC wE��cMD CpINn NN1E 4 1 ,�o.{rrEanveteE rrmcYmmoo wE+! 1 r1 w'A°�wE ID.Ib., ti....NT+a.N NAEM v mTEN s[aewa�wweEyweaaLEe� re.Ewawc C S.V.l• I7 -n 8.c �r llT t� �C�cL Lrlt { L.t. r4wo EaE4LEOp11E'CIWrf.RMl rYETBEowwrA B:RyAy) TZ-A EOUICE THE Erpll ,,,"1R SUFWACEwAIOM VIRAL �wp RPpIR101LIMIVNwa A�AAw.a�aaw T tcr. I TYRE OF EAArLE Ic..+ay...•n A1aalarY ❑ yi�iR�R - �Q Iwwa pyaNwA wEr RwE Oww"wo" ..,REPEAf$MIPLE "'Rwarn CWs*pnrio Wa, pay I I MW$gMCE YMTER gams a NEW CONSTRUCTgN arlwaMlB L.J lawWom OTNEA(%-Nl i I _- uae--- -. RAr aEnawaowourrwan (�7DVACTM CkalaaaRark ❑ (1 ELblpala ❑EOEEYRA �w REOUs iL�JS hsIFarM ❑RrIMWE mrERLwwrrEnRE1w11En TOWLOOLWOMA__MO w E.IOU PwoccOLrOIU—mom Mn OWNT —M+ ANOTNETI EAWLE IwOUwD r41E SUOUNOTi MAM: Twumm Al"U MME: ElEanry ysaN ❑OMWN//YMI �wwgNaww (SL�.,�jl iM1C MRaYNMIM 11AW w1w emod lw 'EL REKRSE 9OE WSW$ WNp.D9ylTy .A wmr w U SffNOJ r''. w"Popi awa WAATERTKA SU(MllEfl G W'Y J I I Lmwks TS IRp L.sbcntmbs.I"e. W S.H.m Sean".WA Wl1 WATER BACTERIOLOGICAL ANALYSIS DAIS CTED TW COC"TE q Om rREDrs»,W ■powsys mcm0I LD.ND.l A "DDIE DFV I 7IW�C-LW�R�[�RirEUOWICI� 1BET1'C'!"G_ 1 Mt/EECyECtr � _'� LR711BIOIREIHIEII:D"rl I sanmEEPe M%M rMiEADIm EfEVMCE ❑ ❑w" ineD ❑swn ❑ re ")%mmm"D" I TR n N �c c M I v k-F F.l TYRDFSM/EEI�"M aRMEY C�R"RI"FDII"PIt_.Tt"--� ❑ YMTFR f"I"E DFRI�aIa�y UDI"IF"DR" I ❑�IIDIIIIP�YIIY wF �MW SDDRCE RNTFR 91u"F�m �wd� 1FW CC"STRULTIpI"MP"RS PaW�" m"ER rsP.IeR -- L "UKMV)DIMSMrEIMMRiLA ❑veATIEFACmRv,t"r"R"r++ ❑ REPEAT ❑EC"F"IF" LOW~ ❑N"IRe"ID Pet"ISEI" (FPMM DMMEg1-- TmLL RED" EDDU now MAICDt"DIM__RM" PUIEGDIRR=lal /anTEiR B"IIE REDWED � &AwtEROTTESRDEECARSE'. LEST IWSIHTWE MCA ❑sRro"m m ❑TMC Tc vaM ❑w.oaD can".v roan Rww C F,sraw" ,ANC777 lwuKMATa7•IDIREWs ww.ROwlsi .� ��� . DT i Di" l oat � I W pIER SUPPER.R�UPY J1 09 13 96 FR1 yfi 2�-Ey uw Mmnq.Inc. LACCIIS 7ESTISG ?�I- C�4.L ®007 94 S,N.T.y b .Rw w•es+m I � Leueke Testing LeOmatprles,Ine. WATER BACTERIOLOGICAL ANALYSIS I �0 9.N""'" S.-M.WA Mice Suva COILECnoN:REAO NSMXT*d ON BACK DE CADENROD CONE SNIN WATER BACTERIOLOGICAL ANALYSIS N latiwpy.w M% wel..Rbb w f.I..rl LE CO=TK*:READ INS,AUcl10NS ON d1CK OF GO De ROD CaT O.TF CT� RYbeypbe.rRMlNeeee,Eeeeb.sl MlEl.wy weN fEN ew � � CdN N.r TE C4IECTED n C bm 9 /i2 p w «E rte.1C, J i IZ i9lo Er w. �*EwoleESTEu nnNueersTTa{oGErEaTr TI1J�— c oo Tm OF swTSE. .q+410 srstfE GGEfRIeTe w, v ['j Zfep1=vlwel I.D.No. {7CIEMyA EreTlb I! Nw DEsrsTw Sd,�r no 2Ef.. E�an.laana.awaewE —m7�ecrc:--- I �s�L1V f,F ►���p� �.V1. IZTN rJf. ar �C�- 1827 seocor. a eana aeoNEw E.NlfLCDueeTtb er:ey.., ' Tii ii (G000 (2--w4d, dLx.T s.sTwoeEERefsa:wwf tnwa I I � R.d1 SL.E,p I T 'N•"' mTo+OWNt31bNk.:e,.,., — spN1uE TrlE GkW W wtlEe tROf115N1E.G wltUENq mum" nE G O°R`�CQ Oww.Xnp Os'MM0 O .�D�GN .na OaKrcE OyGkou+Dw,mucaswE E°Rupp T1O' tibeE.,ene� , w¢l lfslD Q� G Q�. TfoN �-rn.l- l�rTuYy L�.Or Zeno •o-lnw MIL Au F —_ I IX DLPE C 5.. www TwE 7'e.bRFfwa.w..e w.wbf re = �OD —TEkf Co rLV{lfa.awr.rwwey,.y RYI.E --�I I D�MIq uw�.e.O.er a.q fee..rw fb.r —.Rn O^ *sue ue..e.a. Relb..eE.,w,Es I.E. CKPE..i ---- GEs EyT Rwswvw.TER XI NM SOUNUtK m 9"E L. T� �Tl bRnn (",MW SDUfCI w.IEN _ ❑onim Mew �eeE.IM LJl On I NSW CONETRUCTgN..y" � 8 �.ESCEan DINER Is..enyf ewl.�Ie Z OF 2 .ey,RRs_ -- IoFZ RAn um DNEr)Ds.esNs el.Ta sesfnn - ❑UMLTIWCTDNT Cs.M1..M tW use 011rl ;777 V yns etrur lf�..y. EDaww REPEAT ^E.aI.E.A wSMTYCOL n U WOMi TR4 CQYp1Y_-mm�l I�COU n06w TOTK OOLPOw�/ImM E RATE DDNNi T nmw .nptrysk sAIIPIE f1EDyf1lp .4R COUNT 4Q111ER 61MPLE eEDtMND s.NRE NDTTssTlp sfxwu: TESTyeel.iNllE NCeUSG. s.wu uDTTpTeO eEUUSs' TseT ur qurtnµE 9EGull rEef.enwr 1NR Sw^Te m.. CanMxNww Elv.ree r.. Tewaw. a.w mm u sea .TEn. new.R.i. S!l REVE9SE SCf aE DREEM f.OEr Epp gq,yNnp1 O<AMATS ueEoeOaln'q wmfte..fRnEp fLE9E MUS*COF EENCOev EOROV r*NO RESuITS l� J lMoc l y R ' 12-P}� ,.NY RYMA YII TRSEEWNG we 1 WI..TD� 7_27»! Ofl/HGO152�.9/p NmRepbe I,_ eNEfmlm �r� l• G►63 •7 AR.. J BACKFLOW PREVENTION ASSEMBLY TEST REPORT Return No Later Than. Name of Premises: (�.•r 4� ( -�-ve I r File No.: Service Address: 3 Z 5 tnJ t._T S t MOSS t� Location of Assembly-. 12_ 'A"'y ryr�t Set. , sic�t�I Assembly: Fi?6fe;, D/�Yl� lo"." Markvwturer Model Sae 'n Serial No. Line Pressure at Time of Test:� LBS. Type of Assembly: I 1'�) Reduced Pressure Assemblies Pressure Vacuum Breaker Double Check Assemblies Relief Air Inlet Check Valve tat Check 2nd Check Valve Opened at psid _paid DC closed tight Closed tight Ocened at Did not Leaked ❑ Initial Test RP-_ Pstl Leaked ❑ Pstd open ..❑' Leaked . ❑ Repairs and Materials Used Test After DC-closed tight ......❑ Closed tight __ ❑ Opened at Openetl N -paid Repair RP paid _Paid _Psid -t Air Gap Inspection: Required minimum air gap separation provided ........I....1Yes ❑ No❑ Remarks: VGA 1 I6x~ Af eFYJ1AV rL fj Q�/OSS y1�J i s S F l Lr IC LG I4e I� The Above Report Is Certifi To True: Initial Test Performed By: H -, Cert. No.: )9 S S Date: 1 J 1 9/ Repaired By:_ Date: Final Test Performed By: Cert.No.: Date: Water Service Restored Yes ❑ NoEr— usfomer's Srgnahpe ' )4 .. .......�.......� �ry�''�y4. Fp r •p� 4 1 _ n M .d' 1 I BACKFLOW PREVENTION AFSEMBLY TEST REPORT Z� /�/;;IyI Return No Later Than Name of Premises. L'd lip r� t'41 u 1f� File No. Service Address: s2-5 S-J 11t" 5+.- n Location of Assembly: vk 5� 't uv�Ay t w �cl�e °1 Proo-" SMF� s. e r Pas-�f Assembly: Febeo Menuracrarer Able/ Size Send No N. Line Pressure at Time of Test. — LBS. Type of Assembly��14 ( by") Reduced Pre sure Assemblies P•eeaure Vacuum Breaker Double Chaek Assem►Ilea Relief Air Inlet Check Valve tat Cheek 2nd Cheek Valve Opened at psid __paid DC-cosed tight Closed tight 3 Ooenetl at Did not Leaked ❑ Initial Test Rp._ pvd Leaked ❑ —pwo open ❑ Leaked ❑ Repairs and Materials used Test Alter DC-closed light Cl Closed tight ❑ Opened at opened Repair RP_paid —psld _.psttl { Air Gap Inspection: Required minimum air gap separation provided ..,........Yes ❑ NO❑ Remarks: - a.Oy y`trace Lv i, �,yq QtfLTl IsFrL.� Vrlrt (o's The Above Report IS Certified.To Be ue: Initial Test Performed By: Can. No.: S S Date: Repaired By: Date: Final Test Performed By. Ce�Date. Water Service Restored Yes ❑ No� omerb ptatws I I I