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HomeMy WebLinkAboutC_DEEDOFDEDICATION_USSERYRESIDENCE_240110_V3Return Address: City Clerk's Office City of Renton 1055 South Grady Way Renton, WA 98057 DEED OF DEDICATION Project File#: Property Tax Parcel Number: Street Intersection: Reference Number(s) of Documents assigned or released: Additional reference numbers are on page __ . Grantor(s): Grantee: 1. PHILLIP USSERY City of Renton, a Washington Municipal Corporation 2. HEATHER USSERYLEGAL DESCRIPTION: (Abbreviated or full legal must go here. Additional legal on page __ _ The Grantor(s), PHILLIP USSERY AND HEATHER USSERY for and in consideration of mutual benefits conveys, quit claims, and dedicates to the Grantee, the City of Renton, the above described real estate situated in the County of King, State of Washington. IN WITNESS WHEREOF, I have hereunto set my hand and seal the day and year as written below. Dated: Notary Seal must be within box MEIBELLE PEREZ Notary Public State of Washington Commission# 21007408 My Comm. Expires Jan 21, 2025 INDIVIDUAL FORM OF ACKNOWLEDGEMENT STATE OF WASHINGTON ) SS ¾v'<11}.l..t , 20..si...2, before me personally nstrument. Not -ublic in and for the Stat � f Notary (�rint) �\,Ok,\)£ f( �'b. My appointment exp1 res: __..Q.......,_I \+=�'��+-�=--_s:_..,_ ______ _ Dated: � 1-•Q.),:j 7 Page 1 of 4 PTN OF LOT 10, BLOCK 21 , HILLMANS LAKE WASHINGTON GARDEN OF EDEN ADDITION TO SEATTLE NO. 1, VOL.11, PG. 63, IN KING COUNTY, WASHINGTON HUSBAND AND WIFE 3 3342103055 LLC/CORPORA TE FORM OF ACKNOWLEDGMENT Notary Seal must be within box STATE OF WASHINGTON ) ss COUNTY OF KING ) On this day of 20__, before me personally appeared: to me known to be the of and acknowledged the said instrument to be the free and voluntary act and deed of said limited liability company/ corporation, for the uses and purposes therein mentioned, and each on oath stated that they were authorized to execute said instrument and that the seal affixed, if any, is the corporate seal of said corporation. Notary Public in and for the State of Notary (Print) My appointment expires: Dated: REPRESENTATIVE FORM OF ACKNOWLEDGMENT Notary Seal must be within box STATE OF WASHINGTON ) ss COUNTY OF KING ) On this day of 20__, before me personally appeared: to me known to be the of and acknowledged the said instrument to be the free and voluntary act and deed of • for the uses and purposes therein mentioned, and each on oath stated that they were authorized to execute said instrument. Notary Public in and for the State of Notary (Print) My appointment expires: Dated: Accepted by the City of Renton: By: Mayor Attest: By: City Clerk Page 2 of 4 Exhibit A Legal Description Page 3 of 4 Project: WO# PID: GRANTOR: Street: THE SOUTH 1.5 FEET OF LOT 10, BLOCK 21, HILLMAN'S LAKE WASHINGTON GARDEN OF EDEN ADDITION TO SEATTLE NO. 1, ACCORDING TO THE PLAT THEREOF RECORDED IN VOLUME 11 OF PLATS, PAGE 63, IN KING COUNTY, WASHINGTON. Map Exhibit Page 4 of 4