HomeMy WebLinkAboutDeed of Dedication_NORTH_20-01-30/DEEDofDEDICATION.doc\ SMT Page 1 of 4 FORM 04 0001/bh
Return Address:
City Clerkâs Office
City of Renton
1055 South Grady Way
Renton, WA 98057
DEED OF DEDICATION Property Tax Parcel Number:
Project File #: Street Intersection:
Reference Number(s) of Documents assigned or released: Additional reference numbers are on page _____.
Grantor(s): Grantee:
1.
2.
City of Renton, a Washington Municipal Corporation
LEGAL DESCRIPTION: (Abbreviated or full legal must go here. Additional legal on page_______)
The Grantor, _________________________, 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.
Grantor(s):
Dated:
INDIVIDUAL FORM OF ACKNOWLEDGMENT
STATE OF WASHINGTON ) SS
COUNTY OF KING ) I certify that I know or have satisfactory evidence that ______________________
Notary Seal must be within box ________________________________________ signed this instrument 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:
THAT PORTION OF THE EAST HALF OF THE EAST HALF OF THE NORTHWEST QUARTER OF THE NORTHEAST QUARTER
OF THE SOUTHEAST QUARTER OF SECTION 4, TOWNSHIP 23 NORTH, RANGE 5 EAST, W.M., IN KING COUNTY,
WASHINGTON, LYING NORTHERLY OF THE EASTERLY PRODUCTION OF THE SOUTH LINE OF LOT 4 OF ROSE HAVEN,
ACCORDING TO THE PLAT THEREOF RECORDED IN VOLUME 63 OF PLATS, PAGE 10, IN KING COUNTY, WASHINGTON.
0423059237
NE 21ST ST
FIRST UKRAINIAN PENTECOSTAL CHURCH
3
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REPRESENTATIVE FORM OF ACKNOWLEDGMENT
STATE OF WASHINGTON ) SS
COUNTY OF KING ) I certify that I know or have satisfactory evidence that ______________________
Notary Seal must be within box ________________________________________ signed this instrument 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:
CORPORTATE FORM OF ACKNOWLEDGMENT
STATE OF WASHINGTON ) SS
COUNTY OF KING ) I certify that I know or have satisfactory evidence that ______________________
Notary Seal must be within box ________________________________________ signed this instrument 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:
Accepted by the City of Renton:
By: ________________________________
Mayor
Attest:
By: ______________________________
City Clerk
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Exhibit A
Legal Description
Project:
WO#
PID
GRANTOR:
Street:
0423059237
NE 21ST ST
THE NORTH 20.00 FEET OF THE FOLLOWING DESCRIBED PARCEL:
THAT PORTION OF THE EAST HALF OF THE EAST HALF OF THE NORTHWEST QUARTER OF THE
NORTHEAST QUARTER OF THE SOUTHEAST QUARTER OF SECTION 4, TOWNSHIP 23 NORTH, RANGE
5 EAST, WILLAMETTE MERIDIAN, IN KING COUNTY, WASHINGTON, LYING NORTHERLY OF THE
EASTERLY PRODUCTION OF THE SOUTH LINE OF LOT 4 OF ROSE HAVEN, ACCORDING TO THE PLAT
THEREOF, RECORDED IN VOLUME 63 OF PLATS, PAGE 10, IN KING COUNTY, WASHINGTON.
SITUATE IN THE CITY OF RENTON, COUNTY OF KING,
STATE OF WASHINGTON.
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Map Exhibit