21-100247-Deed of Dedication-02-19-2021-V1CITY OF FEDERAL WAY
ACCESSORY DWELLING UNIT
LETTER OF APPLICATION & DEED RESTRICTION
__Tbeing first duly sworn, on oath do hereby certify under penalty of
perjury under the laws of the State of Washington:
That I/we am/are owner of the single-family dwelling unit located at: 67� 40e, Federal Way,
Washington,
Parcel #_ l
Property Legal Description: o,z A)"L LILI LE-�S AJ 71 g ti
L� �S�T o e7q %2 5� ►/y st"%, �� n�Fjc
That I have made application and received City of Federal Way and use approval for an accessory dwelling unit
at this location.
That 1 presently occupy and will continue to occupy one of the two dwelling units at this location as my
principal and permanent residence for six months or more of the calendar year.
That this certification will remain in effect during the period of my ownership of the property unless I record a
certification with the King County Office of Records and Elections that the use of the property for an accessory
dwelling unit has been discontinued. z/
of App
State of Washington )
)ss
County of
On this day personally appeared before me to me known to be the
individual described in and who executed the within and foregoing instrument, and acknowledge that he/she signed
the same as his/her free and voluntary act and deed, for the uses and purposes therein mentioned.
G iYpium4winy hand and official seal on this day of 20 a-\
`�� SONL4
,10�•••• " 0'Nl;",,'' Notary's signature
O T,q r •• O
C ,y q Notary's printed name
9 : j�AlS Notary Public in and for the State of Washington.
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0'.• My commission expires
i 4`4114V64 N
Falsely c�flify� ;4wW occupancy is subject to a civil penalty of $S, 000, in addition to any criminal penalties.