Loading...
HomeMy WebLinkAboutWTR2702842 W-27-2842 BEGINNING OF FILE viu TITLE W �I� I loop a 8�3 1 iiG �d i5 c� J 6 H sg �J C` i I h - [CAG EVA REQUEST FOR PROJECT# lirn.hat (PPA N To: Technical Services Date , ate j Zr�y0p � 2 oeee�# oo / From: Plan Review/Project Manager � J Project Name ! (70 c.=.max) u / Description of Project: CMS (c V Circle Size of Waterline: 8" to. r) 12" Circle One: �N or Extension Circle Size of Sewerline: 10" 12" Circle One: ew or Extension Circle Size of Stomtline: 15" 18" 24 Circle One: N_ or Extension Addressor Street Name(s) ajE Dvlpr1Conuzctor/Owner1Cnsl(:: (70 ncn mu) l C, eck each discipline involved in Project Llr Drwg N of sheets per discipline J J Tra,.s-Storm L (Road+a7 Dn mac) (Off nm u p oun tnuKndudc bu n nam ) r�� (inelud TESC sheen) Transportation (s'p.,iv,donCha cti,don•uaWns) gi Wastewater �,, / Saniury Serer Mam(ra:lud<bu•n name) W Water (Mahn.Vilva•Hydranu) Suface Water a 0 (Includc wmpo6m A Horia ;ww Sbacu) ,&b-ti na Improvements )IWme) _ lS� s TEo-�w ars�1 TS Use Only wwP-2�7-ag43 l t �ac�ti3 ol£S�, — IN-acsy w Return Address: City Clerk's Office City of Renton 1055 South Grady Way Renton WA 98055 001 i 6 csrY or TONaacas t:. a{WW11 Y ee tiI/Iv s Wl NNGO p Title: UTILITIES EASEMENT :::Property:::5Property Tax Parcel Number: 334570-0200 J R0jat Fik 4: LUA 99-039 W 7- ¢ Street Intersection or Project Namc:mar shall Sort Plat Reference Number(s)of Documents assigned or released:Addition-'reference number.are on page— Grantor(s): Grantee(s): I.W" CQ P4' LTA'4- 1 1. City of Renton,a Municipal Corporation 2. The Grantor,es named above,for or and in co®ideretion of mutual benefits,hereby grants,bargains,ills and debven to the above named Grantee,the following dcscnbed property. Additional legal is on page 4 of document. (Ah6rrviared legal dacripdoa,AfUST yo here) LEGAL DESCR11MON: o ABBREVIATED UTILITY EASEMENTS 0 cti A PORTION OF LOT 7 IN BLOCK 4 OF C.D. HILLttAN"S LAKE WASHINGTON GARDEN OF EDE14 ADDITION TO THE CITY OF SEATTLE DIVISION NO. 7 AS PER PLAT RECORDED o IN VOLUME 16 OF PLATS, PAGE 19, RECORDS OF KING COUNTY; 0 SITUATE IN THE CITY OF RENTON, COUNTY OF KING, STATE OF WASHINGTON. 0 o BEING A PORTION OF THE SOUTHWEST QUARTER OF THE NORTHEAST QUARTER OF N l SECTION 32, TOWNSHIP 24 NORTH, RANGE 5 EAST, W.M. 1 ppR � O O aC za EXPIRES 031271lY k I I I H.TORUS'ACRECORDIEASEMEN'T.DOCN Pat,I FORvl 030000,hb'CA0CIJ9 EXCISE TAX NOT REQUIRED King ynt) Recotra Dim.,I BY. ,0" That said Grantor(s),for and in coasiderauon 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 described property(the right-of-way)in King County,Washington,more particularly described on page 1. (or if full legal is not on page 1—Exhibit A.) For the purpose of constructing,reconstrucung,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 slit 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 ruay 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 easement,restore the surface of the casement,and any private improvements disturbed or destroyed during execution of the work,as newly u practicable to the condition they were in immediately before commencement of the work or entry by the Grantee. 2. Grantor shall retain the right to use the surface of the easement w long w such use does not interfere with the easement rights granted to the Grantee. Grantor shall not,however,have the right to a. Erect or maintain any buildings or structures within the easement;or b. Plant trees,shrubs or vegetation having deep root patterns which may cause damage to or interfere with the utilities to be placed within the easement by the Grantee;or C. Develop,landscape,or teautify the easement wea in any way which would unreasonably increase the coats to the Grantee of restoring the easement area Ltd any private improvements therein. d Dig,tunnel or perform other forms of construction activities on the property which would disturb the LCM compaction or unearth Grantee's facilities on the right-of-way,or endanger the lateral support facilities. r' e. Blast within fifteen(15)feet of the rightofway. c" 0 This easement shall run with the land described herein,and shall be binding upon the parties,their heirs, C� 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 o every person or persons,whomsoever, lawfully clairning or to claim the same. This conveyance shall bind the heirs,executors,administrators and assigns forever. y�y� IN WITNESS WHEREOF,said Grantor has caused this instrument to be executed this Ldav of_%"Ip 0 ev i LSDILML AL FORtf OFACCAOrZFDG%IF.NT Noun Seal must be u�Uun boy STATE OF WASHNGTON )SS COUNTY OF KING ) I cen;ft that I know or have satisfactory evidence that __signed"'us'u'instnunent and ace;no��ledged it to be Ismherlthew tree a,.d volun act tor the uses and purposes mentloncd in the tnsttwmcnt Notan Public in atld for he State of LWashington Notan'(Print) Ivly'appointment expires Dated HTORMTKCRECORD'EASEMEN'T.IXk\ Y Pyr2 1 rNDMDUAL FORMOFACLVOWLEDGMEVT Notary Seal must x within box STATE OF WASHNGTON )SS COUNTY OF KING ) 1 certify that I kvow or have satisfactory evidence that signed this inswment and acknowledged it to be his/her/their free and voluntary act for the uses and purposes mentioned in the instrument Notary Public in and for the State of Washington Notary(Print) My appointment expires: Dated: REFRESEMATI s'E FO)Lsl OF ACLVO1s'LPDC.NEAT Notary Seal must be within box STATE OF WASHINGTON )SS COUNTY OF KING ) -; Icertilythat I know"have satsfxtory evidence that Raymond MASS JtY/' signed this instrument.on oath stated that kqNshetthey was/were authorised to execute the insvument and 'c acknowledged it as the (XV}61UA A Ln.t and ao ''J - - of C1l0yv%WQA to be tfic Gee and voluntary,act of such e� party/parties for the uus and purNses mentioned in the instrument. sr� , 0 o 1 tA.tM'7�Q�rvr. Notary Public fir Td Apr tie State of Washington Notary (Print) M ItYl( It Nt u MA n ri My appointme t xpires: °I 1� o I Dated: I��1 ytlTb ca ccw,i CORPORATE tORN OFACENOxlEDGME.W Notary Swl must be within box STATE OF WASHNGTON )SS COUNTY OF KING ) On this i day of , 19_,before me personally appeared to me known to be of the corporation that executed the within Lutrument,and acknowledge the said instrument to be the free and voluntary act and deed of mid corporation,for the isms and purposes therein mentioned,and each on oath stated that he/she was authorised to execute said instrument and that the seal affixed is the corporate seat of mid corporation Notary Public in and for the State of Washington Notary(Print) My appointment expires: Dated. HTOMIMCRECOMEASEMEM.DOCI ravel FORM 030000.bh C.1::1-97 '� r 1 ENXBrT"A" LEGAL DESCRIPTION (`i_+c be rumped by 9 P.E.w L.S.) UTILITY EASEMENT [THAT PORTION OF LOT 7 IN BLOCK 4 OF C.D.HILLMAN'S LAKE WASHINGTON GARDEN OF EDEN ADDITION TO THE CITY OF SEATTLE DIVISION NO,7 AS PER PLAT RECORDED IN VOLUME 16OF PLATS,PAGE 18,RECORDS OF KING COUNTY; DESCRIBED AS FOLLOWS. BEGINNING AT THE SOUTHWEST CORNER OF SAID LOT 7;THENCE S88009'28"E ALONG THE SOUTH LINE OF SAID LOT 7 106.00 FEET; THENCE N01°39'38"E 174.03 FEET; THENCE N88°09'28"W 6.00 FEET; THENCE NOl°52'IO"E 45.56 FEET; THENCE SBS°32'S1"E 40.99 FEET; THENCE NOI°27'09"E 34.85 FEET TO THE NORTH LINE OF SAID TOT 7; THENCE N88°10.20W ALONG SAID NORTH LINE 141.03 FEET TO THE WEST LINE OF SAID LOT 7 AND THE EAST MARGIN OF LINCOLN AVENUE N.E.; THENCE HE EAST ALONG SAID WEST LINE OF LOT 7 20.00 FEET;THENCE S88°I0'20"E 80.00 FEET;THENCE S01°39'38"W 60.67 FEET;THENCE S01036'31"W 6.90 FEET TO A POINT OF CURVATURE TO THE RIGHT;THENCE ALONG SAID CURVE TO THE RIGHT HAVING A RADIUS OF 25.00 FEET,THROUGH A CENTRAL ANGLE OF 90°14'01"AN ARC LENGTA OF 0 39.37 FEET;THENCE N88°09'28"W 6.92 FEET;THENCE SO1039'38"W 20.00 FEET;THENCE o S88009'28"E 7.08 FEET TO A POINT OF CURVATURE TO THE RIGHT;THENCE ALONG SAID CURVE TO THE RIGHT HAVING A RADIUS OF 25.00 FEET,THROUGH A CENTRAL AN("sLE OF 89049'06"AN ARC LENGTH OF 39.19 FEET;THENCE SOI039'38"W 46.03 FEET,TO A POI JT OF CURVATURE TO THE RIGHT;THENCE ALONG SAID CURVE TO THE RIGHT HAVING i. RADIUS OF 25.00 FEET THROUGH A CENTRAL ANGLE OF 90010'54"AN ARC LENGTH OF 39.35 FEET;THENCE N88009'28"W 54.92 FEET To THE WEST LINE OF SAID LOT 7 AND THE EAST MARGIN OF LINCOLN AVENUE N.E.;THENCE S01639'38"W ALONG SAID WEST LINE OF v SAID LOT 7 26.00 FEET TO THE POINT OF BEGINNING. c, N LOCATED WITHIN THE NORTHEAST QUARTER OF SECTION 32,TOWNSHIP 24 NORTH, RANGE 5 EAST,W.M. , 1 SITUATE IN THE CITY OF RENTON,COUNTY OF KING,STATE OF WASHINGTON. ° ;o .1 Bpi ;l EXPIRES 03127 0— H:FOP-%[SI:CRECORLNEASE\IE%T.DOC. Pen+ F00.\I 03 000w'6cA2•2I.97 i i } z °Sy1, /J88"10'20"w 796.0' 1 .y0� o NOl'2709' 0 S88"10'20-E E 8000 3 3f.85 FND. BRASS DISC IN i ^ CONCRETE IN MONUMENT ;.+ 4099 CASE AT SE 8061 STREET AND 1)6Lh AVE NE CITY OF RENTON CONTROL I R SOV36'31'W POINT No 1693 11 W 6.90' S * N88 09'18'W Z Z 6.00' ,n N88'09'28'W i 6 92' R=25 00' L=39 37• n , SO1'39'38'W p=90.1 A'OI' 3 1 MCCp 10 00' 0 1 o: l R=25.00' 1 n Z 58809'28•E L-3919' J 7.08' p=29Y9'06• i 0 b 4 3 U i'ND BRASS PLUG IN GRAPHIC SCALE CONCRETE IN MONUMENT i Z _ R-25 00' a CASE AT SE 681h STREET L=39.35' `I i ON ° 60 - AND 1161h AVE HE i J 1 p=90'10'54- o Z - CITY OF RENTON CONTROL k 1 POINT No 1835 tt 1 1 5 1 N88'09'28_W l IN FEET ) 9 p 54 92 - - 1 inch = 60 It I _ S88"09'26Y 296'0' J'??f'ff' 60' R.O W 1658 94' u � _ ' 9c�0a t 0 L oo0Z r 4 kB870'10"W 2%43' 'a 1� 588.1070E N01'7T09"E g 8000 3 34 85' FND. B:ASS DISC IN\ CONCRETE IN MONUMENT I " 40.99 CASE AT SE 80th STREET AND 1161h AVE NE CITY OF RENTON CONTROL 501'36"31"W 1n N POINT No. 1893. ui 6 90' o 88"0978'W Z 2 6 00' N86'09'18•W 6 92" R=15.00' L=39 37' C Q=90.14'01" lsol'39'3B-W ; p 20 00' < I Z 1 R-25.00' `a I 5880978"E L=39.19' R 7.08' Q=29'19'06" 7 ? ; V FND. BRASS PLUG IN z R_2500 o n GRAPHIC SCALE CONCRETE IN MONUMENT u CASE AT SE 86th STREET J L=39.35' AND 116th AVE NE. I Q=9010'5I \N CITY OF RENTON CONTROL 4 Z I POINT No. 1835 �j 1 N88'09'18 W ( III Fm 1 N p 5/.92 i inch = 60 It o W-09'28 E 156 40 60 , S7g7i'II'y lE � ROW 6 7 9LEoocc t 0 L 000Z Z 43 Return Address.' ttas� City Clerk's Office M1 6sr•i as g.N City of Renton K a N 4t2qJ Yra 2T W CGIIN , WA 1055 South Grady Way i Renton,WA 98055 t BILL OF SALE FL I Property Tax Parcel Number: Project File 0% Intersecnon: Address Refn :. 371 Z Li uee Numbers)of uments assigned or released: Gr Additional reference numbers are on page Grantor{s): Grantee(s): I' ('� L LC 2. 1. City of Renton,a Municipal Corporation The Grantor,u named above,for,and in consideration of mutual bene0u,hereby grants,bargains,sells and delivers to the Grantee,as named above,the following described personal property: ei WATER SYSTEM: Lmmh Size Tyke L.F.of _ ,_ Water Main e _ L.F.of �j Water Main v Ft 1 L.F.of Water Main o _—L_ each of _,4 .. Gase Valves�2 , t each of (s Gate Valves o It each of Fire Hydrant Assemblies SANITARY SEWER SYSTEM: Length Size Type cm L _ L.F.of 1��_ Sewer Main 78b L.F.of D. Sewer Main L.F.of " Seger Main each of 7Via I Utameter Manholes each of 15!r .• Diameter Manholes each of Diameter Manholes STORM DRAINAGE SYSTEM: Length Size Tyke �77—r L.F.of _TM w i/ Storm Line L.F.of __ Storm Line L.F.of _ Storm Line each of �T— f �— �— Storm InlevOutlet i"t — ch of each of �•• 7.� Storm Catch Basin _ Manhole STREET IMPROVEMENTS: (IncludN Curb,Gutter,Sidewalk,Asphalt Pavement) Curb,Ginner,Sidewalk2, r- 1 Asphalt Prvemenr Sy or _L.F.of _ Rldth STREET LIGHTING: Or of Poles By this conveyance,Grentnr wdl wart.mt and defend the sale herehv made unto the Granttt agamst ail and every person er persona,whomsoever.Imvfully claiming or to claim the same This convevance shall bind thr heirs,csecuton' ' administrators and assigns forever r r r.. Ii WILE SYMFBM11414INDOURBILLSAI.E DOONIAB Par I i i IN WITNESS WHEREOF,I have hereunto set my hand and seal the day and year as written belowU�s+0001 n .�1 A19Wt Ji . hVDfROUAL FORMOF ACEN'04'LEDGMENT Notary Seal must be within box 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 voluntary act for the uses ant. )urposes mentioned in the instrument Notary Public in and for the State of Washington Notary(Print) My appointment expires: Dated: REPRESENTATIVE fOR.tIOF ACID\'OIVCEDGsIENT Notary Seal must be within box STATE OF W ASHFNGTON )SS COUNTY OF KING ) 1 certify that I know or have satisfactory evidence that en _ t� signed this instrument,on oath o stated that he/she/they was/were authorized to execute the instrument and ) acknowledged it as the_ and of to be the free and voluntary act of such o partyrpanms for the uses and purposes mentioned in the Instrument. Notary Public in and for the State of Washington o Notary(Print)_ N My appointment expires: Dated: _ CORPOIUTf£OR.N OFACR.V WLEDG.HE, Notary Seal must be within box STATE OF WASHINGTON )SS COUNI 3F K)NG On this_� oy of�QLt3sv8t�.)!(?!�Vbefore me personally appeared Q.LOA18 r be n AS 1 to me known to TQ rtt be of the corporation that 3 ya executed t within instrument,and acknowledge the said instrument to be the free and voluntary act and deed of said corporation,for the uses and purposes thcrem 7 ae, J t = $ menuened,and each on oath stated that he she was authorized to execute said Q Ins ent and that the seal affixed is the corporate seal of said corporation ,h Cf NPR- ota ublic in and for the State of Washington •. Notary(Print)_ act .xn n I My appointment expires:_U U.1 ur Dated: l 1 d d- Page 2 PROJECT CLOSING g1 Final Cost Data /n��y//n���-�,,,-�- I (FINAL COST DATA AND INVENTORY and Inventory SUBJECT: IV i •'` \ CITY PROJECT NUMBERS: WTR• S4a� t Ky WWp. SWP Name of project TRC 1 . ,__D- TO: Cityof Renton FROM: y�.ye+yGM Plan ing/Bu Section ��remz_Planning/AvinueSouth WorksTyyr�=^w gyg+2 200 Mill Avenue South ��d Renton,WA 95055 DATE: I'L^2 , e0 Per the request of the City of Renton,the following information is iumished concerning final costs for improvements 1 installed for the above referenced project. } WATER SYSTEM CONSTRUCITON COST$; ~ la'I�37— 11 Length Size Type ` 5el)Ok0 l2[c L.F.of S _ ` �_ WAT7RMAIN t3:i ,q L.F.or �_ • A_I WATERMAIN S •T Ir"tJ3fl4 •— L.F.of + _ _ V _ WATERMAW t{5P't — 6 �w LT of �— WATERMAIN J J V' Ir{)I47 _I EACH of GATE VALVES I'tcv— 1 EACH of GATE VALVES t"Isr _. Z EACH ofs GATE VALVES qou — �G�A1 �PXo�J'YZ. 1 EACH of tZ_ FIRE HYDRANT ASSEMBUES $ (Cost of Fire Nyd. ds mush be hsted sepnratelyj Z9a, S (Include Engineering and Sales Tax If applicable $ TOTAL COST FOR WATER SYSTEM S SANITARY SEWER SYSTRM� STURM DRAiNAGiSY7TEM Len in Ize Type _ :.engih Site Type L.F.of SLVM MAIN II I61 _ '7 8 L.F.of _lam �2 STORM LINE Lk.of SEWER MAf 2Z '?G L.F.of STORM LINE L.F.of SEWER MATT L.F.of_ -- ^ STORM LINE EA of Lim F DIAMETER MAMIOLES t`1�s n' Z• EA of ' STORM INUrr/OUTLET t EA of t DAMMR MANHOLES 3�cs _�_ EA of Z L STORM CATCHBASIN tlncluding Engmeefing and Sala Tax EA of STORM CATCHBASIN if applicable) S (Including Engineering and Sala Tat TOTAL COST FOR SANITARY SEWER SYSTEM _S_ _. if applicable) S TOTAL COST FOR STORM DRAINAOE SYSTEM $ a4tiatq STREET IMPROVEMENTS. (Including Curb,Gutter,Sidewalk,Asphalt Pavement and Sir Lighting) L'L1��31 30000 — As ifSSt - g244 Slpewr.\� i129 308f)" �� �i� SIGNALIZATTON: (Including Eng.Design Costs,City Permit Fees,WA St Sales Tax) STREET LIGHTING. (Including Eng.Design Costs,City permit Fees,WA St Sales Tax) Print signatory name day phone N ��au' , I fomWCOSTDAT?.DOG (SIGNATURE)bh ;Signatory must be authorized agent or owner of subject development) r PROJECT CLOSING LI Final Cost Data FINAL COST DATA AND INVENTORY and Inventory SUBJECT: � CITY PROJECT NUMBERS: WTR. WWP- SWP- Name of pmjwl TRO ' TED- TO. City of Renton FROM: litkxRa� LL� Plan Review Section 22?2(o e6 Ly,Te, Z20 planning/Avenue Works w�µ�q�t 200 Mill Avenue South Renton,WA 98055 DATE: I I 00 Per the request of the City of Renton,the following information is furnished concerning final costs for improvements installed for the above refererl project. } WATER SYSTEM CONSTRUC71(uCOSH ` (4)j3) Length L.F.of Size �7yy� 1 SNu..a+L .— E9jo'lo en —� _& WATERMAIN 3tZ-8 dtw� — `t afat4 L.F.of �_ . bI WATERMAIN Af90 -- L.F.of �_ _ Df WATERMAIN aib`A`t '— S +Z Is•tJ.3�st L.F.of WATERMAIN bw IaT 13'7 EACH of GATE VALVES 1af0e— t EACH of GATE VALVES 8^15_— z EACHof � I GATE VALVES 4pd lcnTAl lm'?La—' EACH of _�� FIRE HYDRANT ASSEMBLIES f �---a_ (Cost of Fire Hydra..❑must be listed separately) 2gd $ �-- (Include Engineering and Salos Taz if applicable S T OTAL COST FOR WATER SYSTEM f SANTCAR7'SEWER YCTrM s.. STORM DRA(NAOE(c 4YCTF'M _— L.F.of Sze SEWER MAW I7,des length Size Type _ L.F,of SEWER MA[zt?ki7 — L.F.of til 2 STORM LINE I'I" L.F.of STORM LINE L.F. f SEWER MAW L.F.of • STORM LIVE EA of R17 • DIAMETER kLkNHOLES 0%sn•— Z EA of urr EA of --+Jra _ • DIAMF1MR MANHILET 3o0:— _ I EA of �(_ STORM STORM CAT�CFIBAUS (Including Engineering and Sales Tax EA of STORM CATCHBASN tN if app4ubl<) -5— ,,..ram (Including Enginweing and Sala Tax TOTAL COST FOR SANITARY SEWER SYSTEM _ > 517j pa � if applicable) S —T TOTAL COST FOR STORM DRAINAGE SYSTEM STREET IMPROVEMENTS- (including Curb,Gutter,Sidewalk.Asphalt rAVcment and Stregl Lighting) - -+)-►�� R Z�3 30toU—" tom` — 8244 StDtW.�\� 1120'� 308U—' � ���2AN=• —y_ SIGNALLZATTON: (Including Eng.Design Costs.City Permit Fees,WA St Sales Tu) STREET LIGHTING: (Including Eng.Design Costs,City permit Fees,WA St Sales Tax) Itmt signatory name day phone a fonns/COSTDAT2110.'uh (SIGNATURE) (Signatory must be suthorized agent or owner of subject development) ✓ Return Address: City Clerk's Office City of Renton 1055 South Grady Wdy Renton,WA 98055 BILL OF SALE Property Tax Parcel Number: Project File 0: 1 eat Intusection' Address. Refereaee Number(s)of Uccuments assigned or released;Additional reference numbers are on pageL r Grantor(s): Gnnlee(sj: I. I. City of Renton,a Municipal Co 2, p Corporation The Cantor,as named above,for,and in considmnon oC mutual benetlts,hereby grants,bugeins,sells and delivers to the Crantee,as named above,the following described personal property: WATER SYSTEM: Len tg h Size T e IZc., L.F.of _ Water Ma!n L.F.of Water Main L.F.of Water Main each of A •. Gate Valves J 2 ee If each of Gs Gate Valves each of Fire Hydrant Assemblies ISANITARY SEWER SYSTEM: Length Size _TY� L,� L.F,of (I Sewer Main 7R19 L.F.of _ �__ Sewer Main eF,of •' Sewer Main each of Diameter Manholes each of ., •. Diameter Manholes each o: Diameter Manholes STORM DRAINAGE SYSTEM: Length Sim T_2s L.F.of `-•• . f// Storm Line L.F.of _ Storm Line_ L.F.of Storm Line _ — each of _ _ each of Storm 1nIeVOutlet �— each of Storm Catch Basin Manhole STREET IMPROVEMENTS: (Includ�Curb,Gutter,Sidewalk,Asphalt Pavement) Curb,Gutter,Sidewalk z-F L.F Asphalt Pavement: SY or�_L.F.of Width STREET LIGHTING: 0 of Poles �__ By this conveyantt,Gnntor will wamnt and de4nd 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, administrator I asaigrs forever. H'U ILL.SYSV'RAIUOFMDOIfIsBI LLSALL.DOCUI Ali Pape 1 r1iA NU. K U3 Laucks Testing Laboratories, Inc. l 9e0 S.Hs'ney Star*WA 9b10B �1 ' WATER BACTERIOLOGICAL ANALYSIS SAMPLE COLLECTION:REM INSTRUCTIONS ON BACK OF GOLDENR00 COPY If Imtrucbona ere not followed,ample will be reiv~ DATE COLLECrEO TIME COLIECT�D COUNTY NAME 1 MOATH WY vW TYPEOFSVSTEM if PUBLIC SYSTEM,COMPLETE: ` •�f L` j PUBUC ❑INOVIDLAL I.D.N0. r O e1I GROUP nw A.rl w.orNe O V NAOR OF SYSTEM I ESPECiLOC KNFNf 9ANNLE E6 TELEPHONE NO •3dre• r^P+IG+11 pia, DAv �7fe 5'94- 193J Loo 4„�01.. Awn, YN't. EVENING SAMPLE COLLECTED BY:INane) SYSTEM OWNENMOR INonnl toy, _Aloo'.1 SOURCE TYPF GROUND WAY ER UNDER SURFACE INFLUENCE ❑SURFACE (B WELL P, ❑SPRING ❑PURCHASED or Q COMBINATION WELL FELO INTEATIE or OTHER S A POUT TT la11 F 1 NFmN, oe n yp TYPE OF SAMPLE IcNNck ON,ono in INIo FaWmnl ❑ROUTINE DOWNING WATER ❑ Ndm1 CeW(AhId,W _TDlel.__Fne) cnen mt,minl ❑F,n~ ❑Uninmp or OUDr ❑REPEAT SAMPLE -_— Pm.wucaAampnNPnu Ue e��� au—I'—'— F❑RAW SOURCE WATER Saner P❑S m ❑Tom r nilonn Ip NEW CONSTPUCTIOM or REPAIAS ❑Fecal ColTam ❑OTHER 15pKdy1__ _ i PEMAANS- ILAB USE ONLYI DRINKING WAT"RESULTS V UN$ATe,EACTORY,DOnb,mP Pnwnl SATISFA.OW 1 REPEAT CPHamo NPMN SAMRES ❑E.CoI pneN O E.CF aoaPrl AfOUIRFL ❑FKN DniNm PLiJ FKN aeaem OTHER LABORATORY RESULTS TOTAL C0LI10RM - 10pm E.COU I!00ML FECAL COL F AM n00 m1 PLATE COUNT .YN 1 ANOTHER SAMPLE REC"RED SAMPLE NOT TESTED BECAUSE TEST UNSUITABLE BECAUSE ❑Ssiwoap ❑CaINVomgwYnn ❑V Iq Cwt1ne, ❑TNTC ti,C mPvnq I,,- ❑TJ,ad CWWn U ERCRI con, 1 SEE RWJMSE 510E OF GREEN COPY FOR EXPLANATION OF RESULTS Ue NO I,=In, DATE "ME AECENtp I AEcHvto eY r t AEPDIRED UPDRAMR, 113 I