91-101506CITY OF FEDERAL WAY
33530 First Way South
Federal Way, WA 98003
BUILDING PERMIT
BUILDING INSPECTION
661-4140
91-1463 NR LITOWITZ
CONSTRUCTION 6421 27 ST NE
PERMIT NO. OWNER'S NAME SITE ADDRESS -----
LITOWITZ—OWNER POB 4892 FEDERAL WAY
CONTRACTOR ADDRESS
LITOWCI121BW 1/92
CONT. PHONE -927-6116
927-0411 SAME
CONT. REG. NO. EXP. OWNER'S PHONE OWNER'S ADDRESS
XX
TYPEJOB: NEWRESIDENCE ADDITION NEW INDUSTRIAL
NEW COMMERCIAL COMMERCIAL ADD. INDUSTRIAL ADD. NEW PUBLIC PUBLIC ADD.
NEW MULTI -FAMILY (UNITS MULTI. ADD. SIGN
GRADING OTHER ...AND GARAGE
TAX ACCOUNT NO._ 252103-901 LEGAL
DESCRIPTION LOT 11 BLK 24 OF SAMUEL OSBORNE' S 1ST ADDN PIERCE
CO WASH ACCD TO THE PLAT THEREOF RECORDED IN VOL 9 OF PLATS PG 63 OF PIERCE CO WASH
ELIZABETH SNYDER
ISSUED BY DATE OF ISSUE r DATE OF APPLICATION 10/17/91
BUILDING INFORMATION
ZONE RS 9.6 SET BACKS: FRONT 20'
SIDE 5 /5 REAR 51 HEIGHT LIMIT 30' MAX
OCCUPANCY R3/M1 TYPE OF CONSTRUCTION 5-N
CENSUS NO. 101 TYPE OF HEAT GAS BLDG. SQ. FT. 1941 STORIES 2
PLUMBING NO. NO.
MECHANICAL APPLIANCES AMT. AMT.
BOND
WATER CLOSETS 3 ELEC. HOT WATER HEATER _
GAS PIPING 25 FT. 2.00 GAS LOGS
BATHTUBS 2 LAUNDRY DRAINS 1 _.
FORCED AIR FURNACE GAS 10-00 DUCT WORK
RECEIVED
SHOWERS URINALS
GAS HOT WATER HTR. 6.50 AIR HANDLING UNIT
NUMBER
LAVATORIES 3 DRINKING FOUNTAINS
CONVERSION BURNER MISC.
1
RETURNED
SINKS MISC.
BBQ BASIC FEE
DISHWASHERS 1 TOTAL FIXTURES 11 X $5.00
DRYER TOTAL MECHANICAL 18.50
AMOUNT _ NONE____
VALUATION $100,206
PLANNING DEPT
APPROVAL = DEB BARKER "NO BUILDING SHALL ENCROACH ONTO
ANY BUILDING SETBACK LINE OR EASEMENT, SHOWN OR NOT SHOWN.
PERMITFEE $643-00
SIGNIFICANT TREES SHALL BE RETAINED & PROTECTED PER FWZC
PLAN CHECK FEE 418 OD---
—$125.00
90.15.4 — SEE ATTACHED"
PLUMBING FEE 5 S _ 00
-CHANICAL FEE I g - 5D
FIRE DEPT APPROVAL = KEVIN ELLIS & PAT KETTENRING
PART P/C FEE (293-0-0Y—
PD 10/17/91
SEPA REVIEW
#4109
PUBLIC WKS DEPT APPROVAL = SUZI CUZZETO "DOWNSPOUTS MUST BE
PUBLIC WORKS 45-00
TIGHTLINED INTO STORM DRAINAGE SYSTEM LOCATED IN PIERCE CO.
S.B.C.C. FEE 4_50
(LOT 11, BLK 24 OF SAMUEL OSBORNE' S IST ADDN) . DRAINAGE
FIRE FEE
DATE:
Ji SYSTEM SHALL BE OPERABLE PRIOR TO FINAL CONSTRUC
OTHER FEES
AMOUNT:
` C.� APPROVED SYSTEM, POC BOB GALLAGHER 591-5505
AMOUNTDUE $R9-1 00
RECEIPT:
ao
BLDG DEPT APPROVAL = KEVIN ELLIS
ALL PERMITS EXPIRE 180 DAYS AFTER ISSUANCE IF NO WORK IS STARTED. RESIDENTIAL AND GRADING PERMITS EXPIRE ONE YEAR AFTER DATE OF ISSUANCE.
I CERTIFY THAT THE INFORM I N F RNISHED BY ME IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY REQUIREMENTS WILL
BE MET.
OWNER OR AGENT
DATE
ION
CITY OF FEDERAL WAY
33530 First Way South
Federal Way, WA 98003
BUILDING PERMIT
BUILDING INSPECTION
661-4140
PERMIT NO.
OWNER'S NAME SITE ADDRESS
CONTRACTOR_
ADDRESS
CONT. PHONE
CONT. REG. NO.
_ EXP. OWNER'S PHONE OWNER'S ADDRESS
TYPEJOB: NEW RESIDENCE
ADDITION NEW INDUSTRIAL NEW COMMERCIAL COMMERCIAL ADD. INDUSTRIAL ADD.
NEW PUBLIC PUBLIC ADD.__
NEW MULTI -FAMILY
(UNITS ) MULTI. ADD. SIGN GRADING OTHER
TAX ACCOUNT NO.
LEGAL DESCRIPTION
ISSUED BY
DATE OF ISSUE DATE OF APPLICATION
FONE
BUILDING INFORMATION
SET BACKS: FRONT SIDE REAR
HEIGHT LIMIT
CCUPANCY
TYPE OF CONSTRUCTION CENSUS NO. TYPE OF HEAT BLDG. SQ. FT.-_
___ STORIES
PLUMBING NO.
NO.
MECHANICAL APPLIANCES AMT. AMT.
BOND
WATER CLOSETS
ELEC. HOT WATER HEATER
GAS PIPING FT. GAS LOGS
RECEIVED
BATHTUBS _
LAUNDRY DRAINS
FORCED AIR FURNACE DUCT WORK
SHOWERS
_ URINALS
GAS HOT WATER HTR. AIR HANDLING UNIT
NUMBER
LAVATORIES
DRINKING FOUNTAINS
CONVERSION BURNER MISC.
RETURNED
SINKS
MISC.
BBQ BASIC FEE
DISHWASHERS
TOTAL FIXTURES
DRYER TOTAL MECHANICAL
AMOUNT
VALUATION
PERMIT FEE
PLAN CHECK FEE
PLUMBING FEE
MECHANICAL FEE
P/C FEE
aRT
PA REVIEW
PUBLIC WORKS
S.B.C.C. FEE
FIRE FEE
DATE:
OTHER FEES
AMOUNT:
AMOUNT DUE
RECEIPT:
ALL PERMITS EXPIRE 180 DAYS AFTER ISSUANCE IF NO WORK IS STARTED. RESIDENTIAL AND GRADING PERMITS EXPIRE ONE YEAR AFTER DATE OF ISSUANCE.
I CERTIFY THAT THE INFORMATION FURNISHED BY ME IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY REQUIREMENTS WILL
BE MET.
OWNER OR AGENT
DATE
SET BACKS AND FOOTINGS
DATEBY
OX TO POUR FOUNDATION WALLS ,f
DATE/DATE_/�..._.BY ....
PLUMBING GROUNDWORK
DATE _�1- y_y/ __BY
PLUMBING ROUGH IN',"�,n��/
DATE{ .BY .`�—.._.
WATERLINE O.K. __— _-_
GAS PIPING O.K. __ --j' -`i 2
MECHANICAL INSPECTION
DATE _ 3_ r Z -BY _ __-
O.K. TO ENCLOSE FRAMING
DATE j~S ry_ _ BY _ _—_
INSULATION
DATE _�.. `BY _ ......--. _
WALL BOARD AND FIRE WALL
DATE —3" 23 "-�2 _ BY
FINAL O.K. TO OCCUPY
AIi170el y
DATE_, BY.. --
DCD
PSD
FD
1.2- y2QXli
i/LG
r�r sl —
/ ro/=i� c.^'Prez 40
^s
d1 /1 /ti /1 A? U �r /2/1 /7 F/NTS ,.
mi
0 0
Per ' ( -
RFciEnIED
CITY OF FEDERAL WAY
OCT 1 ? VAAL A� BUILDING PERMIT APPLICATION 4�' ` q
( p�[)FO -- Please Print "
fjIJILD,
BOX 1 TENANT NAME: LiTW)Tz- Cov5`rraL7" a. lee.
OWNER LtT'DW tTZ ( PA]t I& SITE LOCATION (= . t C , J 1 lk,
OWNER'S ADDRESS FOYi +SV, CITY_ FF D PHONE SR- 6114
DESCRIBE JOB CoN9T¢.(d_T _
THE PROPERTY IS OWNED BY: SINGLE/MARRIED PARTNERSHIP CORPORATION
BOX 2 CONTRACTOR'S NAME LITNITZ (I0k) TI0&)t_jW_ CONTRACTOR'S REG. # I-1TDU1C I IZI 13W
Card MUST be presented
CONTRACTOR'S ADDRESS PDT 481z- CITY F�-D>�� U% PHONE qZ7-6((6
EXPIRATION DATE 1'`IL
1•
I HAVE READ CHAPTER 18.27.010 RELATING TO DEFINITIONS OF GENERAL CONTRACTORS AND SPECIALTY CONTRACTORS AND
CHAPTER 18.27.110 WHICH PROHIBITS ISSUING PERMITS WITHOUT PROOF OF REGISTRATION.
r)
BOX 3 CONTACT PERSON OZ- &INNy PHONE92 V-0*11
BOX 4 SEWER DISTRICT WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST 4 t5S000 EXISTING BUILDING VALUATION -&-
BOX 6 PROPERTY TAX ACCOUNT NUMBER ZS -/03- 403l-0�
LEGAL DESCRIPTION dN PLOT 'PL"
(It necessary, please submit a separate page with the legal description.)
K.C. Plat Recording # 318S933 3/874'43F 33/S.S3o
BOX 7 BUILDING SQUARE FOOTAGE: (Existing/Proposed) 1ST FLOOR / I(49 2ND FLOOR /
3RD FLOOR / BASEMENT / ZSG DECK / GARAGE / SDG
BOX 8 ( SINGLE FAMILY ( NEW CONSTRUCTION
( ) MULTIFAMILY (NO. OF UNITS = ) ( ) EXISTING STRUCTURE
( ) COMMERCIAL/INDUSTRIAL TOTAL AREA OF PROPERTY I( moi( 3 SQ FT
BOX 9 PLUMBING FIXTURES (including rough -ins)
MECHANICAL APPLIANCES —
BASIC FEE $
NO. 3 WATERCLOSETS
GAS PIPING, FEET _ ZS
$
r'
Z BATHTUBS
NO. t FURNACE, ELEC. GAS
$
-46
SHOWERS
ZGAS HOT WATER HEATER
$
3 LAVATORIES
CONVERSION BURNER
$
1 SINKS
BOILER, SIZE BTU
$
I DISHWASHERS
AIR HANDLING UNITS
$
ELECTRIC HOT WATER HEATER
HEAT PUMPS, SIZE
$
I LAUNDRY WASHER OUTLET
UNIT HEATERS
$
URINALS
AIR COOLING UNITS, SIZE
$
DRINKING FOUNTAINS
COMMERCIAL HOOD
$
SUMPS, SPRINKLER VACUUM BREAKERS
__OTHER
$
_DRAINS
$
_ OTHER
_
$
lL—TOTAL FIXTURES
—
$
TOTAL MECHANICAL FEE
$
l$• S U
CERTIFY UNDER PENALTY OF PERJURY THAT THE INFORMATION FURNISHED BY ME IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE
VD FURTHER THAT I AM AUTHORIZED BY THE OWNER OF THE ABOVE PREMISES TO PERFORM THE WORK FOR WHICH PERMIT APPLICATION IS
7E. I FURTHER AGREE TO SAVE HARMLESS THE CITY OF FEDERAL WAY AS TO ANY CLAIM (INCLUDING COSTS, EXPENSES, AND ATTORNEYS'
INCURRED IN INVESTIGATION AND DEFENSE OF SUCH CLAIM), WHICH MAYBE MADE BY ANY PERSON, INCLUDING THE UNDERSIGNED,
'-ED AGAINST THE�ATY OF FEDERAL WAY, BUT ONLY WHERE SUCH CLAIM ARISES OUT OF THE RELIANCE OF THE CITY, INCLUDING ITS
'S AND EMPLOYVES. UPON THE ACCURACY OF THE INFORMATION SUPPLIED TO THE CITY AS A PART OF THIS APPLICATION.
rF!W_w2N_., E., � - M,
ANP -008 3/90
ZONE 5q•(o SETBACKS: FRONT_
PLANNING DEPARTMENT APPROVAL
REMARKS: M)
OFFICE USE ONLY (PLEASE DO NOT WRITE BEPW THIS LINE)
z o'
/ 0
SIDE 5' REAR 13' HEIGHT LIMIT '301
SEPA: EXEMPT 1, NOT EXEMPT
FIRE DEPARTMENT APPROVAL r.L DATE u ` �- q
REMARKS: y'wa-F " Pc+ 1'rtK�
PUBLIC WORKS DEPARTMENT APPROVAL :�9� 4 DATE
REMARKS: Uoj4l 3i d— Ajj_,;f A5 -;r76h4-r41 WP 6c/T0 S _,*eM Q2i3'I:Vi4C],-_
"r /! i 84040L` a4 of Ss3,auEL 4 BAWAlf_"s
�v rJ K uv L
TYPE OF JOB: NEW RESIDENCE ES. DD/A T
r , ct,�xC� �1-KC/1 �/ r `S) o
NEW IN USTRIAL IND. ADD/AL
NEW COMMERCIAL
COMM. ADD/ALT
NEW MULTIFAMILY
(UNITS )
MULTIFAMILY ADD/ALT
TENANT IMP.
OTHER
OCCUPANCY
TYPE OF CONSTRUCTION
STORES
�ul Sr
BUILDING SQ. FT.
7-)220 @
7Z-�(C = Z�S�q<�
BUILDING SQ. FT.
(r'LN @tr
= a37(oz 1
G V-0- q
BUILDING SQ. FT.
�_Ob @
(��. Cr = Z � q 8
BUILDING SQ. FT.
@
_
BUILDING SQ. FT.
@
_
BUILDING SQ. FT.
@o
✓I�tc c �(2tr '-� py
TOTAL SQ. FT.
100
TOTAL VALUATION 10 D ZC G'' 7 ,
BUILDING DEPARTMENT REMARKS:
RECEIVED
PERMIT FEE
PLAN CHECK FEET__
PLUMBING FEE
MECHANICAL FEE
TOTAL BLDG. FEES
PART P/C FEE
SEPA REVIEW
S.B.C.C. FEE
OTHER FEES
AMOUNT DUE
ASSIGNED ADDRESS: � Z I Zl , ,A, /l - G .
PARTIAL PLAN CHECK F E RECEIVED
Amount Date Al( Receipt #
V
BUILDING DEPARTMENT APPROVAL I
BY ! DATE `✓ ✓
0
J� ■ / 33530 1 ST WAY SOUTH . FEDERAL WAY, WASHINGTON 98003
October 31, 1991
Litowitz Construction, Inc.
P.O. Box 4892
Federal Way, Washington 98003
Subject: Building Application Permit #91 -1463 -NR
To Whom It May Concern:
We have reviewed your permit application for the above referenced project. The following
information and design must be submitted in order to continue our review.
1. The stormwater runoff from the proposed building must be tightlined to an approved
storm drainage system. Please submit a design for collecting, conveying, and dispersing
the stormwater runoff from the roof and footing drains per Section 5.4.2.2. of the Kine
County Surface Design Manual. An infiltration system should be used if soils are
adequate.
The soil log and infiltration rate shall be prepared by a professional engineer or
geotechnical engineer, licensed in the State of Washington, or by a certified septic system
designer. The design shall conform with Section 4.5 of the 1990 Kine County Surface
Water Design Manual, a copy of which is enclosed.
2. To verify ownership and the legal description of the property, please provide a deed
or title.
3. Indicate existing and final grading contours on the site plan.
If you have any questions in regard to this matter, please contact me at 661-4143.
Sincerely,
Suzie A. Cuzzetto
Engineering Technician
c: Ron Garrow, Senior Engineer
d4�, e-� %a eew ,C-
f/��,,. sic ary � w. avvav� �%
.dz`�a�u fir ,�i/�ul/r/� ,� �tu�l,�t � Gni
/1 tea, �1d/K�ra'� ✓yew � ��u.�J.
r.>v � z� � �f ,YF a �; �,�� �C
�'.�Qu+l /lb./ 7�ie�u�f�ayy -��/ce�lCv ,gym .eo
���i! CtX��ilo1 .'e �f 1,6� C.
Q CT 7 ASSA
"AL WAY
' a'1005-41
Amount of Insurance** $
`
Premium'. $ 200,00
0
SCHEDULE A
5333,00
`.
'
Date of Policy� JULY 5, 1990 AT 3�41 P.M* .. .
�
10 Name of Insured**
Order No.** H674687
'
LITOWITZ CONSTRUCTION, INC., a Washington corporation
2, The estate or interest in the land described herein and which is
covered by this policy is fee simple and is at Date of Policy vested
in**
THE NAMED INSURED
'
3° The land referred t' in this policy is situated in the State of
Washington, County of KING and described as follows*,
SEE ATTACHED EXHIBIT "A-1" '
,
K`~�' .
-
Coontersigned____~________�__�___~�p~________�__~_________
Authorized Officer or Agent
0
EXHIBIT "A-1"
Order No°� H674687
That portion of Government Lot 2, Section 25, Township 21 North,
' Range 3 East, N~M^, in King County, Washington, described as
follows�
Beginning at the northwest corner of the west 330 feet at a point
380 feet south of.the north line of Government Lot 2;
thence east along said south line of the north 380 feet of
Government Lot %v a distance of 62°5 feet to the east line of Samuel
Osborne's First Addition in Pierce Countyr produced north't
thence south 223^8 feet to a stone monument being the northeast
corner of Lot 11v Block 24r Samuel Osborne's First Addition;
thence northwesterly along the Pierce -King County line 92 feet to a
point 159 feet south of the point of beginning; .
thence north 159 feet to the point of beginning^
END OF EXHIBIT "A-1"
'
0
Order No-** H674687
SCHEDULE B
This policy does not insure against loss or damage by reason of the
followioQ*+
PART I*+ d area, which an
tions of locatioo' boundary an t eets,
1
Encroachments or questions Public or private easements,
s r
^ �e survey may disclose; p» d f record by recorded
aco«ra or highwaVs, unless disclosed o d� rights or claims
roads' alleys decree of a Court of recor t
plat or conveya»ce" or claiming �o be in possession° »o
` s in possession» or c labor liens or liens
of persons b� the public records � material or ab the poblic
disclosed tioo Act not disclosed� i
under Workmen's Compensation relating thereto; any sery ce»
records; water rights or matters re er water' electricity"
reco construction charges for seu '
installation or c
or garbage collection and disposal~
tions in United States Patents or in Acts
and exceptions control or
2
Reservations---- �� right of use' c
^thereof; � f powers
^ t�orizing the issuance ," ^^"''-i- in the exercise o
ao�n b the United States �� America the use, occupancy
regulation y bibition or limitation o» e public
over navigation; a»� pro d resulting from the rights o� the po to
or improvement of the la» which may cover the land or
riparian owners to use any waters w r may formerly have been
or portion of the land which is now o
use any p
covered by water,
~
ble� matters relating to special i g
3 General taxes not now paya if aoyv preceding the same becom »
assessments and special leviesv
a lien~
`
PART II� `
1^ GENERAL TA%ES*# 1st half delio9uent May 1; 2nd half delinquent
November 1^ 1990
Year*+ $98,54
Amount billed*+ $49,27
Amount Paid'# $49^27
Amount due** 252103-9031-07
Tax account No^*+
Levy Code** 3491
Assessed Value Land* $ � ��
Assessed Value Improvement� ^
2 EASEMENT AND THE TERMS AND CONDITIONS THEREOF*
^ Water pipe ��o�
^ -- � ^ l line of said
PurPosm Near the westerly
Affects** premises 1941 August 3�° 1941 and
August 22° °
Recorded**JVne 11 1943 d 331553O
31859n3187723 an
Recordin'l��`^: ~��y
---.- .- ^,rccc +" And from the land^ . '
ASS;,Y.E� F i _:A9:.:'
, P •'iAr'C':FAC:ES '.:I7H:N 'HE SKE :g
• ♦ ...,,,., 1tJt Sii0CL0 EE :ASE ;C A S!:Ry EY FOR FCR-.HF.R :`1-fL A :C;N
PAGE
i
LO.T BLOCK
SEC. LS 'Z,I
RANGE
001 FSAID PREMISES IS, MtMENCING ON THE NORTH TINE
rel I
SW 356TH z 97¢Q 03_
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1s7i si _ r. 7e s.i i)oroseS7e. w
9a K •SP176 1$ 1 �I .3.7A - i 3p iSo Z 30 . 30 �3t
`sB`::.1% -
76041
0504 3 �:� 25
sc r�
W �Mf Ih LoT / 1 LoT t v
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�_1.. i ::-. j! % 1 •4: .... i Lits. 1 7 c wf*• V . l iA— iJ. _._..... e.-.
1
EASETO
;1
For a,' valuable conrilderatioM :rece]Pt of wWch Whoro y soknowledged, tie Gra.zitvr
hereby gxWAA---std amvey_.�_._._-to tha GcAntec_-------
SU. ccsso.C5 and 7+ vifpis, the right,, privilege ane &jItIlLixity to CQTISiLUCL, 1TYIIJrQPG', repair and
mailr'tpiAl
------------------------------
sacT'Oss, OvP` rE,nii upan tt5.10 1911e+wtng ►mid. located iwas-11hieu.)", to-wit;.rt_.__.Vter'�,�,,, _..__-._ _.._COUuty, State of
`� 1•�I LL �Orfr� of Chi V 0 1 i1 M �
�r t 1
r ��c�c.� l�� r �Go; x� bt4Cr�.t io�.�� UJ49 +"5 �r.► .
I
1; The Grantor-__., filaall ma.kc, xaL1 llE:ta of t11P IAPB occupied by +o ld------------------- ------ --
In exercising tete rights l-jerein . ran+:ed, thy: ~_�_.____..__. _-__-- •----„------„----------- ----
Grantee---_ h1Y_.. $Uccessrrs �Lnd assigns, may Lass
and reuses over sai.d____J�:f'�u.�ti�VcY•�,_.._--.--..__.-
_..---------------------------------
ma.y cut and remove br>js34a, treat and, other obztruttaorls which in the opitaion of L.11,Grantee__-- in-
terfere,
{j
i:_---- ...---- .. ---- ----------------------------------
+ '.etc cbve>sa nt, i rmla� eor;ta4lna,� Safi run with the lard alfa are binding upon all. subsequent
(ice, i1l,'C.i 1;71P.rF:t:31r_
f
,�-
i�aca�.c, s+c aaau ai4 iFllWF nQ__--AxeCt]'Ge(: bb ir1'1t2'RrY1enV tile__ -�-
day -
Exp
%
4
__�. ----------- --
iMaNniton Up i Monk Co., uslime, W&
loww tom
RECEIVED
7
pERmff,l q % — l`f &�x /Z_
f
M
THIS iNilI;'TURE WITNESSETH: n10100360
the ownar i of the property hotreinaf..ter described, Cor atld in conalderation OE the sum of
Ona Della 1.51,L+�) etitd good and va:,awbl.e cnc,SLdCrdLloll to _1;, in hand paid by the
Cite of T4cotA, a muntrcAj�al corpordtion, the receipt of whXch is hereby acknowledged, ham
gx.autad and dolma htreby- grant utity raid Cirl of Tacoma 4he perpetual right and privilege
to canvtruct and vAintair, ever, under, along and across
:hu Fc I.I..aiary dascxLbed K}sil P:-vperty gttuass in Pi.ec,e: County, Washington, to wit
n CT 1 6 1991
Lot lt, Block 42A of S3:±iuei Csborne's 1st Addition, Pierce County.—,
ttashio9t,jn accor69nr to the plot thereof recorded in Volume' 9 Df ' "'''�4-
Plats at Pagz 63, records of Pierce County, Washington.
,tagtther Witt,. tine cIFOIL to enter upcln said Premises at any t.me with all necessary men,
rAttr"I and AFFlit.ncP�s Kar rhe p,.srpOses Of construcLi.ng, inspecting, operating, repairing
and mointai.n.ing the usatnt! and further providing that the trantor., his heirs, assigns or
OtP;Caesors atidil. erect no permanent struct�ase witl;f.n the easement area unless specifically
Apprnved in wrieing l:,ti• IAte City's Director of Public, Works.
114 WITNESS VHDREOY I have) haraunto subacr.ibed M n�ame� at f;ace�a,
Wa4hingtnn. this day of
Undividual A6ai&a14JBamaa0
COUUTY
On ',itis day personally appealed Lefore Ino
to me knor.m to be tha individual dr.acrl.bvd
(Cot -?orate Ack.no/wledgemenc)
COUNTY OF )
on this --day - L9`
btfute me Personally .appeared_
Lt' arc! vho Ax4cuted that s i.thtn .tend £cregoing
inatr=Qnt., and acknowledgad thML—*w— to me known to be the
_aisnud the some an
frea and voluntary act and deed —Toz the
un4sa And purposea therein mentioned, --' - — -
cive,�' undaz my hand errad cs££icial.,a1l�y�s?j��'
VA fit►
Notary PublIC in and for tha 5tat4% opelf'`-
t
Waah-Lngtort, residing 41t _—___ �'s�'�%k •r Wf+►�
Jaacri tion Approved: C
_..Su
Form Appfsv4ds t:_ /
' 't <�i,ty Attorney
FWK 4DO WS t+.',901
oEXhe corporation that executad the forogoing
na ument, and acknowledged said instrument
the Free; sr,d voluntary act and deed of
6 1=orporatiori,fti�r
"I
as .
n mentioned, and or, ath statad that i
was/were authorized to ex -
Ce Said instrument.
In witness whereof I have hereunto cot my ttiand
and affixed my official. Baal tha day and year
first written above.
Notary Public in and for the State ofrn
r:ysldIng at
REV{81� 1.1
RECEIVED
OCT 2 4 1991
PMr#� �3��
r
IS
Is 62.5
0 0
I -F F'I
tai AM
�i iai19mwn� WE'
�rpl ii MEMEM=M
ME ME at
9 4
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