HomeMy WebLinkAboutWTR2702871 WTR-27-2871
i
BEGINNING
OF FILE
SHOREWOOD
•
Laucks Testing Laboratories,Inc.
940 S.Harney Seattle.WA 98108
WATER BACTERIOLOGICAL ANALYSIS
SAMPLE COLLECTION:READ INSTRUCTIONS ON BACK OF GOLDENROD COPY
If Instructions am not followed,sample will be nelected.
GATE COLLECTED TIME COLLECTED COUNTY NAME
MONTH My fAR
// 0
;l 01 -®+AM- : PM 1nq
TTHE OF SYSTEM IF PUBLIC SYSTEM,COMPLETE:
PUBLIC �'T c ^
INDIVIDUAL \GROUP
1 ary r iwlaelEel L.�i
NAME OF SYSTEM
P'
on
SPEOFIC LO QIIWF6ESIAPIF COILECtm TELEPHONE NODAY 'c
JEA 24 EVENING 1
y��tX1LlECTED aY:IN•hN SYSTEM O :SNarrlel
^ . . ;" Ell
SOU RCETYPE LjGROUNDWATFA1 ACE INFLIENCE
❑SURFACE C3 WELL or ❑SPRING ❑PURCHASED or❑COMBINATION
WELL FIELD INTERTIE or OTHER
SEND REPORT TO:(Print FUII Nal Address and Z,p Code)
L.
K, wn,He ron
TYPE OF SAMPLE(Check only one In diis copp,Wphnr NR�e�eItl
❑ROUTINE OChipgDa CEIVEDtaI Free,
DRINKING WATER L �aa check tree\meet qry '
❑Unbeated or Other__._..
❑REPEAT SAMPLE JAN 2 9 2MI
REPEAT
SAMPL presence LaD
0.1. UTIU�N 1 r T_ FTyI:�ON
❑RAW SOURCE WATER Smnp1O �Ell Total Coekdm
[2 NEW CONSTRUCTION or REPAIRS ❑Fecal Cofai
❑OTHER ISWdy)
REMARKS:
• (LAB USE ONLY)DWMM 1a YSATER RESULTS
P UNSATISFACTORY Cohlonne presnd ❑SATISFACTORY
REPEAT ❑E CdI ❑ Coslorms abeam
SAMPLES Pr°s""t E.Cdi aDaent
REWIRED ❑Fecal Mean ❑Fecal absent
OTHER LAaORATORY RESULTS ----
TOTAL COLIFORM_A./100 ml E.COLT-A MOD ML ---
FECAL COLIFORM /100 ml PLATE COUNT __/ml
ANOTHER SAMPLE REQUIRED
s
SAMPLE NOT TESTED BECAUSE. TEST UNSUDABLF BECAUSE
• ❑Sample toc old ❑Coneuent growth
e ❑Wrong ,ontalne, ❑TNTC
•❑EnconpMe Iona ❑Turbid CUXe,e
❑ ❑Excess deans
SEE REVERSE SIDE OF GREEN COPY FOR EXPLANATION OF RESULT S
LAB NO IT DIDITSI DATE.TIAE RTCENED I\ECEtVED By
15) � -4,
DAIi nio, lA!'IMIORr r
1 � 1
eera\xe
IXaI seReaN asp
WATER SUPPLIER COPY
Laucks Testing Laboratories,Inc.
940 S.Harney Seattle,WA 98106
WATER BACTERIOLOGICAL ANALYSIS
SAMPLE COLLECTION.READ INSTRUCTIONS ON BACK OF GOLDENROD COPY
11 instructions am not Mlowed,sample will be rejected.
DATE COLLECTED TIME COLLECTED COUNTY NAME
MONTH MY YEAR /r .� /
f �/1 o f 50AM ❑PM J(i
IVPIE OF SYSTEM IF PUBLIC SYSTEM.COMPLETE: --
L UKX �.�
®❑ L La Ib. 7 / S 5- le, C c ae fP
Lr/�.aY,ee4se C y
NAME OF SYSTEM 77 1
SPEW LO ONWIIERE SAMPLE COLLECTED TELEPHONE NO.
Nyf,/ J 4'. } DAY
J� F'r
r ,,,,La�'r.i
� I N'Inw.'Y.i EVENING
IsE_COLEECTEcal Msr,M1 J SYSTEM OWNER*".:INstnsl
TI 1 "K f` I
SOURCE TYPE U GROUND W.uER UNDER SURFACE INFLUENCE
❑SURFACE Q WELL w ❑SPRING ❑PURCHASED p ❑COMBINATION
WELL FIELD INTERTIE POTHER
SE REPORT TO:(Print Full Nome.AtlOn o end Zip Codel
/. A'r
� i t
I .. r�6wwtoe
t OIF OF SAMPLE(d',eck only one M eW coWmnl
ROUTINE G WATER Cnlpinated(RBAdusl. TOM
HOUTIN —
cnacF trealmant ❑Flllano
❑UnI.ted p Otber_ __
REPEAT SAMPLE
P —If collp preeente Lab s
Date -�-�a� ED
❑RAW SOURCE WATER Spline• ti 1 T' } VI 200hotal CdHdm
NEW CONSTRUCTION p REREPAIRS CITY LJLfFmjTT F O aiNr,n NaI c
❑OTHER
REMARKS. /1 '
/ I-
,u 13 USE ONLYI DRINKING WATER RE Ull
❑UNSATISFACTORY,CdOp s pesenl ❑SATISFACTORY,t
REPEAT ❑E.Coe Pmmt ❑E.Cob absent
SAMPLES
REWIRED ❑Fecal Present ❑Fecal absent
OTHER LABORATORY REBUETS
TOTAL COLIFORM f{ 100 ml E COLT A_/100 ME
FECAL COLIFORM /100 m1 PLATE COUNT_AN
ANOTHER SAMPLE REWIRED
SAMPLE NOT TESTED BECAUSE: TEST UNSUITABLE BECAUSE'.
❑S.Ple too ow Consuent Smwtn
❑Wrpy cant,w TNTC
❑Incpnpm.form Turbd cueun
❑ ❑EsceM 0e1,11s
SEE REVERSE SIOE O, GREEN COPY FOR EXPLANATION OF RES JS
LAB N0.(!DGIiS) DATE.1Ma]RECENED RECENEO BY
M1E LIEPOmEO LsaORATp1Y
WATER SUPPLIER COPY
t
A
INTERPRETATION OF RESULTS
FQI4 DRINKING WATER
rile Ynai;,SG periw-wd on Rvs umxcmq",atak sample oa an
bon too Ise{)RtSMr'n t7r rOnhN'n nmMroi,n 7t'rt•.eater anti IRrAE81e9
the CAEterx+tny al q)lairty of the saa»mgFe,'ine phr:gfA cp.Ot Gc9Nor,- -
a,ganly nsis;rapd by nweltn orynnr'atum»wandwI&.:u art indlcat:r
mr the PO$66ble t>raverke a other daease cau5+nq OrE,jan)yny
REMi2BTINO OF 89-M&M
t*vhjo A Pub4c Water Systems must roport the results
WAtel Ari to the Stale 2•_.rWined In WAIT 24G 240,4r,
SA7t&MASr OM RMJv%
Inc ablzmaxa= luptg
! yme NowrI
A
ATIEL
protec� e ^ 5C1rYtpt y.
rY;iw xstx�erJfltxi
"Confluant Growth"sea
mesa wt,"rrmkt�rnunt",,
k::a lmmcruQs t,count."Exc,r .
the watts lntelf+bv 'a 1," mh;.poo wiwu u'.
CUttum"mPflns an of 0 wv
•,i(`i nj dnJl�nu°R.�r..lil'/ban indlC.9bP,f18ni
..,Pre��)cr n'cua(<�+m bacteria Jautd sat E,a.r,�tevn`.u)+,a aM a rww
...r)Pi@ mu5:h,offiUIneC4(J!".in.8�'afJ,
RESAM?4E:
:\ii`1t)IQ!tin INU 1:'Wft+{yC a rk3t�:; _ I[-rii '1 Wrtnut„i; tti aR�+
Not ✓.. proFpi ",wtdule•.. (F}:)Illy„ G. rK• 46y�i v..:v ;I 1.0
pu,cnased from a cWw,,,; ,jb VnCh+n t5
Im,uftioretV voiurnt,h5ampo oil.m by it iftsp 'I W nw
if � ,;4`st64.a pyw'.8ample mum be%luo rtlr{tY to,amu,w&
FOR AGWIMA1.1["RMAL":
Ca;111,1 t volm IOCLI he:4lth daFoodm:r.Il OR the,Iabn..tlwy wher9 11M,'..
sample.wAs totted OR the (1epArtmant a1 waalth, OfInkonn WMIk'
Pr;V�YattLRagla�{Tal C7RCl,
f
I 1
JAN-26-2001 FRI 09:29 AM KING 00 FAX 410. 2968431
A ,
— Laucks Testing Laboratories,Inc. !—.) Laucks Testing Laboratories.Inc. ,^
1 94C S.Hanel• SellMe,Y 98T08 940 S.Harney Seattle.WA 98108 I
WATER BACTERIOLOGICAL ANALYSIS WATER BACTERIOLOGICAL ANALYSIS
SAMPLE COLLECnON!READ INSTRUCTIONS ON BACK OF GOLDENROD COPY SAMPLE COLLECf10N:READ INSTRUCTIONS ON BACK OF GOLDENROD COPY
N instruction are not IOBowed,"Nesle WIB be relBoted. N mirucBen5 are not followed.SelnOle all be rejected.
04TE COLLECTED TIM'E'COLLECTED OUNT+•NAME DATE COLLECTED 11"ECOLLECTED COUNTYNAME
MONTH MY vEM :_ / I MONTH W YEAR ��:_�
/ > ai �AtA ❑� F1^ I ,y OI i'0 ❑AA in/
TYPEOFSYSTEM IFPUSLCSVSTLkLcompLETE: TYPEOFSYSTENA IFPUSLOSYS'EEM•GOMFLETE:�—�
RUSLIC CIR GROVP PUBLIC c�{GROUP
❑INDIVIDUAL �. . O. 7 S c 6 ❑INDIVIDUALLD.NB. ? I S ac LJ e
ne+r"W1nWHrw Iv•wwYrwercn
NAME OF SYSTEM ` NAMED SYSTEM
I SFEORC CK"w�'�E SAMPLE COLLECTED TELEPHONE NO. SPEdF C D v SMO E COLLECIEO TELEPHONE NO.
Ef�n.f 61q /706/3 Y si76 Scr9-/973 H�pliave S+4 ISI $9 DAY .0OG 994fa7�
H.L. 'Z4't
SSA p COL fd MININGSt»rE i"I 24f- EVENING
SAMP COLLECTED BY.(Hamel SYSTEM OWNEWM�jRR:Ia/ym.I SAMPLE COLLECTED BY Skalnol SYSTEM OWYEWy1GR.:(Nalnof
SCURCETYPE GROLNOWATEquNDERSURf EINFLUENCE SOURCETYPE 'GROUNDWATERUNOER$U ACEINFLUENCE
[]SURFACE ?SWELL er CI SPAINO I]PURCHASED cr❑COMBINATION ❑SURFACE QWELLa ❑SPRING ❑PURCHASED W COMB NATION
WELL FIELD WERT'.E or OTHEP WELL FtEID INTEPTIE wOTHER
SEN RE RT TO:IPdnl Fit'NATO. SISZV do) eE T WmI FRI Narno,Address and LP Code)
Merl no Atl�"�` O�a EFi 41 110EL �rtnb
loss SC�1.a.L� Q2..y 1,12
..,Ya a, 9 f0 47"
TYPE OF SAMPLE(CbeCk only one In due eakerW H 'YPE OF SAMPLE(Chock only,M In Mia Column)
❑ROUTINE ❑ ❑ROUTINE CnlonnatM ,N
DRINKING WATER CPWrpitotl lRpltlual._TM,II_Free) DRINKING WATER ❑ (AdIdut, Told_e
rneTA tAumerl ❑Fllloratl cwkl:Nlment VFTPsd
❑Unlmaletl P,CIA. ❑,fnlryelM aOtnH_�_,_ _
❑REPEAT SAMPLE ❑REPEAT SAMPLE
I"Yorl ColAmm P-MuN Lab a PnYICR eo'Aonn pral Labe_,
Due—/_ram— Date .—1
PAW SOURCE WATER Source a E• ❑Total cc 11 m ❑RAW SOURCE"TEA Source'�$ ❑Total Conrorm
g.NEW CONSTRUCTION a REPAIRS ❑FacTl Coldo" S�,'NEW CONSTRUCTION W REPAIRS ❑FeGa Conlorm
❑OTHER(SPecIN). OTHEa,$poC�M__
REMARKS'. -•b. 886 I� REMARKS /, ,D• O G /
(US USE ONLYI DRINKING WATER RESULTS Vl1 (LAS Use QNLLY)DRINKING WATER RESULTS
❑UNSATISFACTORY.C.140 ma DreeMl ❑SATISFACTORY, ❑UNSATSFACTORY CaORrma p,eeant ❑SAT SF ICTOAY
❑
REPEAT E.Con MATent Coldon"ebeenl Cot,=aboom
SAMPLES ❑E.Cau absMl SAMFS PPL ❑E.Cof waaem ❑E.Con ebeent
REQUIRED ❑FeCa1 pgpnl ❑Faeel eMant REQUIRED ❑Fecal DrKont ❑FCW abM,,:
OTTlilt LABORATORY RESULTS aw, OTHER LABORATORY RESULTS _
TOTAL COUIDAM.A_1100 mI F.COLAAll DO M. TOTAL COL FORM a it UO mI E.COU_ ,100 M.
FECAL COLIPORM•—„It 00 ml PLATE COUNT_AYI FECAL COLIFORM_1100 ml PLATE COUNT_ort
ANOTHER SAMPLE PEONRED ANOTHER SAMPLC PEOUIRED
SAMPLE NOT TESTED BECAUSE: TEST UNSUITABLE SCCAUSF. SAMPLE NOT TY$TEO BECAUSE: TEST UNSUITABLE BECAUSE:
Cl Sarno at too a a ❑ConMlant gr,Wlk ❑sampN mold ConrudM gq.rtA
❑wrong.ammnc, ❑TNTC ❑Wgng canianM ❑TNTC
❑MPanna m form ❑Turnrt,Cu Tun ❑InammGieto farm Turbw cunum
❑--.. ❑E.Cwe oeerd ❑ Eecow doors
SEE REVERSE SIDE Of GAEEN COW FOR EAPLANATION OF RESULTS SEE REVERSE SlOE Or GREEN COPY FOR EXPLANATION OF REWLTS
.AS NO.lI 010ra1 0.f.THE 766E5p _PEECFrvEO Sr UMIM2 17DIGTS1 OATC.TIME RECEW10 RECENED By
Og l 'hIS-)- Ila oI ly'.3u :
CUE REApATEDJ lAtldM' Y DME A[F aTC� NEDM
P,.Yo Px YKY..NI nr Yn N:,.cY.w
`C 000 a 4.
ShoriPlait'(S(IPL
REQUEST FOR PROJECT0 Prelim Plat (PPN
CAG N )
To: Technical Services Date WOk GrecnN
From: Plan Revicw/Project Manager �� I 1 eun
Project Name f±c)rewovc,(-
Description of Project: QCtt4�� I r.4( '1 FQ I //
tcrm FsI S i� � '' CAS i 105 I�-, 6 '' ( �+•� � JCL
rr is1 c�,rh gL-H�r +- �idPu )CAk
Circle Sire of Watetline: �8 10" 12" CircltOne: Now or Extension
Circle Size of Sewerline: O 10" 12" Circle One: New ot( F.xtensiq�;
Circle Size of Stormline: I2" 15" 18` 24" Circle One: New or Extension
Address or Street Name(s)
Dvlpr/Contractor/Owne nslc: Cry nLr, nG
M'k g: --�r�— ch+ mn m )
r6C1 in Q — �V�(Y32t^
Check each discipline involved in Project L'.r Dnvg N of sheets per discipline
O Trans-Storm
(Ro�dw,er/Druivac) (Off ci�iryNremrruxmelude bLin null%I (Incl.&T[SC(h"u)
O rransportation (slpWiludenChu cliudoaU&Unt)
0 Wastewater
S-i W-y Scwv Main(:,,luck buin nunc)
O Water (Mina,V:Jra,Hydrant:) �^
(IncWdc mmpntim C Horiunul Ctr1 Slwc W
O SUface Water V O O
.. Improvements ( );.,lade buin"ar )
TS Use qn1y
U. rW W.
?-air
aQ�
Return Address:
City Clerk's Office
City ofRenton CITY ov Itcnrow es
1055 South Grady Way esc/1ie/ieairliee13
Renton,WA 98055 a2N0 collrlrr, tM
BII L OF SALE Fp_0/_ 0 Pnperty Tax Parcel Number: !f yppii. t
Project File M: Z&?/ Sty� on,, Address
A/ /7/ NG ZYx
lCe—fereace ntor Namberta)of Documents assigned or released:Additional rc enace numbers arc on page
Grantor(,): Grantee(s):
I, At.J, F. Hot01;V41 , Fit, 4 VA. (rap. 1. City of Renton,a Municipal Corporation
2.
The Gnotar,a named above,for,ud;n coatidcnti 1: 1 mutual benefits,hers:by grants,bargain:,sells and delivers to
^o the Gnat".as nand above,the following described posonal property;
WATER SYSTEM:
Size
w iype
3S L.F.of V„ I, gip, Wet-Main
co L.F.of Wata Main
o L.F.of Wet
Main
each of Gate Valves
ct •. each of /t' Gate Valves
each of Fire Hydrant Aasernblies
SANITARY SEWER SYSTEM: Lan T
StLe
/ro L.F.of S3 I.
G Sewer M.ein
7ZZ L.F.of — 6 " •• G 900 _ Sewer Main ,
L.F.of Sewer Mein
-- each of y Diameter Manholes
each of � Diameter Manhole,
/ each of �p••• Diameter Manholes
STORM DRAINAGE SYSTEM: Length Size i°
2Z3 L.F.of 7Z '• G/£P Stor .ne
L.F.of Storm Line
L.F.of __ Storm Line
each of _ Storm Inlet/Outlel
each of WC/ Storm Catch Basin
/ each of 7WK Ir Manhol
STREET IMPROVEMENTS: (including Curb,Gutter,Sidewalk,Asphalt Pavement)
Curb,Gutter,Sidewalk 247 L.F.
Asphalt P,vemenf SY or Z47 L.F.of • >;t W
STREET LIGHTING:
idlilk
N of Poles fq A
d' 001- ()C_ l in a conveyance,Grantor will warrant and defend the sale hereby snsdc unto o the Grantee against a 1 and e
or pinions, m and auver,s,omvly claiming or to slum the same. This cony very person
administrators and assigns,'Drover conveyance shall bind the heirs,executors,
:I IFILESYS)FRM�61IiNl>(ArM ILLS A l 1.BCX'Ut AB
1•age 1
PROJECT'CLOSING RI Final Cost Data
FI AL COST DATA AND INVENTORY and Inventory
SEAILY�hA9 NC IYL'6f Fr�raab,B
SUBJECT: :5 T[�AK�• � CITY PROJECT NUMBERS: W(R• J(S 7I
57DNE e,ef6.TZE �FOY�.a� "fMsrlt•b+0•,� swP- Z F7!
Nam
Na of Project TRO_ Zf7/
TED- I! 7 l
Ta City of Renton FROM: `E/djO,L�ph ,O<V, S✓L't
Plan Review Section IZ6/7• R , St'
Planning/Euilding/Rtblic Worts $D7N4L4, aJA 47"e-1
j 200MillAvenueSouN A(64 : A4,'94C ,CO^4A 4
Renton,WA 98055 DATE:
i
Per the request of the City of Renton,the following information is fumishod concerning final costs for improvements
installed for the above referenced project.
! wATER SYSTEM CONSTRUCTION COSTS:
Length Stu Type
L.P.of WATERMAIN
Q37 LF.of f3,• WATERMAIN
LF.of WATIERMAIN
LF.of WATERMAIN
_3— EACH of _� ' 0,/.7.— GATE VALVES
/ EACH of /Z GATE VALVES
EACH of GATE VALVES v$
EACH of IM HYDRANTFS ASSEMB I S ♦ _
(Cost of Fire Hydrants must be listed separately)
(Include Diginecring and Sales Tu if applicable
TOTAL COST FOR WATER SYSTEM $ 5-7,7Z- O D
SANrMY SEWER SYSTEM: SPDRM DRAINAGE SYSTEM:
Length Stu Type Length Site Type
f LF.of PV G SEWER MAIN Y 3 LF.of /Z ' era, STORM LINE
7L L LF.of SEWER MAIN LF.of ' STORM LIKE
LP,of —/— ' SEWER MAIN LF.of STORM LINE
•3 EA of y a DIM4M-ER MANHOLES EA of sl uRM INJETroDITET
Z EA of S(V/LD"• DI MEIN MANHOLES _( EA of STORM GTCHAASw
(IarAuding 8ngineeringw Sales Tas BA of STORM GTQIAASM
it applicable) s Aw W 7•n a Onclading Engineering and Sales Tax
TOTAL COST FOR SANITARY SEWER SYSTEM 3 //�(a L L g O if applicable) _s 33 v 3/3 &0
TOTALCW 1 IPoR STORM DRAINAGESYSTEM
STREET IMPROVEMENT'S: (including Curb,Gutter,Sidewalk,Asphalt Pavement and-fitrecHightiol) AXeZ. TsvJi NatC RaoT rrita0
NE "q IEV. Fw»e CL -2M_ e6&eA&sr oh[y % L(o7 if Vito4, 4*hl-;
_/N90 SF. f.att A S'a IaGK r ]� N•C. _AC- pS �L L'osf_ Q SZ'1 'a
SIGNAI.IZATION/(Including Eng.Design Costs,City Permit Pas,WA St Sales Tax)
STREET LIG IG: (Including Fng.Design Costs,City Permit Pees,WA St Sales Tax)
11;j�4AE'4- 77_- 1",410 <yzc�yP� ZrG3
Print signatory name /�day phone 1,
(SIGNATURE)
fwmWOSTDAT2D0(7bh (Signatory must be authorized agent
or owner of subject development)
m s .m.n N.acc.s CAN
i
Y � 1
F a + �.... I � r - !a/�I��� •ram o .oav�s�A � '
•yam --*-- �-'- - _ � t!
' R-207107 F� w
AS-BUIlT8 `
as aro� .�=• '� � E I
i-�Ta�iu; • + M Iur��
1•.. �+ I — I CROUP FVUR./ne.
!iwran C.uL NNOW _ i
`�-"a.A Tau uN l I I fO11F YW
� w
ROM 173 255
Return Address:
City Clerk's Office
City of Renton CITY Or RiNTCN BS B.N
1055 South Grady Way s111/1 B=1612:13
Renton,WA99055 KING COUNTY, tla
Q,Ztl.,7tLU
BILL OF SALE p.D/- 0 Property Tar Parcel Number: 5$yjr0 r t;
Project File N. Z87/ Street lnte ttnon: .ldareaa;
UC lYg 7 �// r7/7 /VLsy�
Hefertace Numberts)of EWuments assigned or mleased.Additional rc erence numbers are on page
Grantor(s): Grantee(s):
r` I. N.J. F. Hoet>iNtr{ , r.c, a, &)A. Ca p. 1. City of Renton,a Municipal Corporation
c� 2.
to The Grantor,as named above,for,and in consideration o' uaal benefits,hereby grants,bargain$,sells and delivers to
the Grantee,as named above,the following described pets ..'propc:ry:
-'� WATER SYSTEM: Len Size Type
�n 31 L.F.of g,• G.I.P. Water Main
$.o L.F.of •' ___ Water Main
.� L.F.of _ Water Main
each o! _ Gale Valves
c�
each of /L' Gate valves
ee _ Z` each of :ire Hydrant Assemblies
SANITARY SEWER SYSTEM: Length Sin _7
/70 L.F.of >91/L Sewer Main
UZ L.F.of G APO Sewer Main
L.F.of Sewer Main_ each of y Diameter Manholes
each of Diameter Man;iolu
/ each of 60 Diameter Manholrs
STORM DRAINAGE SYSTEM: 1--Zh Size Type
-ff43_ L.F.of /Z & Ir P Storm 1,nc
L.F.of _ Stonn Line
L.F.of _ Storm Line
each of Storm InleUOmlr
�— each of 7YO;// Storm Catch Basin
/ each of _y ./t Ir Manhole
STREET IMPROVEMENTS: (Including Curb,Gutter,Sidewalk,Asphalt Pavement)
Curb,Guner,Sidewalk 2 L 7 L.F.
Asphalt Pavement: SY or l67 /
L.P.of • S Width
STREET LIGHTING:
B of Poles - j
Hy this conveyance,Grantor will warrant and defend d¢sate hereby made unto the Grantec against all and every person
or persons,whomsotver,lawfully claiming or to claim the same. This conveyance shall bind the heirs,executors,
administrators and assigns forever.
HMIFILE.SYSVrRMWHNDOUTV3ILLSALE.DDCWkB Page I
r
i
Form as 0001/hh
IN WITNESS WHfi�REOF,I have hereunto set- my hand and seal the day and year m written below.
l/Ii..0�Ql/Lt.X� A�—
I
INDMOUAL FORMOFACENOWLEDGMENT
Notary Sal must be within box STATE OF WASHINGTON )SS
COUNTY OF KING )
I certify that t know or have satisfactory evidence that _
signed this instrument and
acknowledged it to be histher/their tree and voluntary ac: or the uses and purposes
mentioned in the instrument
Notary Public in and for the State of Washington
Notary(Print)
My appointment expires:
Dated:
REPRESENTATIVE FORM OFACKNOWLEDGMENT
Notary Sal most be within box STATE OF WASHINGTON )SS
lZa COUNTY OF KING
sett I certify that 1 know or have satisfactory evidence that
o _signed this instrument,on oath
o stated the, he/she/they was/were authorized to execute the instrument and
m
acknowleuged it as the_ and
of to be the free and voluntary act of such
to ies for the uses and e. party/pvt purposes mentioned in the instrument.
o Notary Public in and for the State of Washington
N Notary(Print) — - --
My appointment expires-
Dated:
CORPORATE FORM OF ACKNOWLEDGMENT
Notary Seal must be within box STATE OF WASHINGTON )SS
COUNTY OF KING ) [OD t
On this�day of HOY ,kp_,before ma personally apl,cued
s
��IGaR,..... 556 It NtCw,.�t J• F(5Lre"OQAJ to me known to
y1':�`'SSIOly� lit be ?Xe51Ce7r1 --of the corporation that
f t O NOTI�), III executed the within instrument,and acknowledge the said instrument to he the free
p and voluntary act and deed of said corporation,for the uses and purposes therein
mentioned,and each on oath slated that hdshe was a-,Norized in execute said
Illl s�'• �' i instrument and thatthe seal affixed is the corporate seal of said corporation.
i
IIItx Wl�S -Nat ih an or the of Washington
Notary(Print)•Zm-' It i-
My appointment expires:_09,A) e)(4
Dated: s 7 o/
Page 2
fI
1
PROJECT CLOSING R_i Final Cost Data
FINAL COST DATA AND INVENTORY and Inventory
SE s)a I"nxlA/C tYt'st f nut+,B
SUBJECT: CITY PROJECT NUMBERS: Wm- _
WWP- _ 7+74
$70NE eAWZE Lronaaw� "fMK1..a+e sWP• 2F7
Name of project TRO� PY 7/
TED• L(7/
TO: City of Re:nun FROM: I�N�J,I�'�Ys 04y. rye'j
Plan Review Section 1f2/7- R dove r&"
Planning/BuildingMsblic Works _QDYAWCLL, A.)A 9110L/
200 Mill Avenue South Asfw : Af.•Fr �C.w.,tA�o
Renton,WA 98055 DATE:
Per the request of the City of Renton,the following information is furnished concerning final costs for improvements
installed for the above referenced project.
WATER SYSTEM CONSTE fcn N COSTS
Length Sim Type
L.F.of WATERMAIN
Q39 L.F.of R" WATRMAIN
LF.of WATEtMAIN
LF.of WATFRMAIN
EACH of LT " .0 0 GATE VALVES
/ EACH of /I '• •• 0• OATS VALVES
EACH of GATE VALVES !Y
EACH of - FIRE HYDRANT ASSEMBLIES S �Ao yj
(Cost of Fire Hydrants must be listed separately) AV 3111
,Include Engineering and Sales Tax if applicable s
TOTAL COST MR WATL•R SYSTEbt s s7. 7L, ,O D
SANITARY SEWER SYSTEM: STORM DRAINAGE SYSTEM-
Lafh
Size Type Length Size Type
yn L.F.of I SEWER MAIN y13 L.F.of JZ ' "Cew STORM LINE.
77 Z. LF.of L SEWER MAIN L.F.of STORM LIF
L.F,of T SEWER MAIN L.F.of STORM LINE
EA of Y a DIAmrFrR MANIIOIFS EA of STORM INIETIOVII.Er
_ Z_ EA of SV"ILO" " DIAMETER MANHOLES EA of STORM CATCHBASW
(Including ErWric sing and Saks Tax EA of �_ /L"�STORM CATCHIJASIN
Ifapplicable) s /oLVS'7•d+ (Including F4necrms and Saks Tax
TOTAL COST FOR SANITARY SEWER SYSTEM s //V.LGL• 00 ifapplicable) $ 30 3//33 .0,0
I V I AL LUST FOR STORM DRAINA'-E SYS'r (.,iM S j
STREET IMPROVEMENTS: (including Curb,Gutter,Sidewalk,Asphalt Pavement artto 8 ee In go 9) Iva. xwwa gC Ror r~
-_NE 2 N b sT, X % Z497 [F 01,4- f wla
1y9c sr' cbyl'-t , s ra = Nc �: 7 k C� PSL -� L.
SIGNALIZA/L"O'N: (Including Ting,Design Costs,City lWmit tees,WA St Sales Tax)
M _ —
STREET LIGLe (Including Eng.Design Costs,City permit Fees,WA St Sales Tax) —
Print signatory name a1phone a
(SIGNATURE)
GxnV(7OSTDAT2.I1DMh (Signatory most be authorized agent
or owner of subject development)
SEE
DRAWING(S)
I