560 HEMLOCK WAY.PDF11498
560 HEMLOCK WAY
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BUILDING PERMIT (NEW STRUCTURE) #:
COVENANTS (RECORDED) FOR:
CRITICAL AREAS #: DETERMINATION: Ej Conditional Waiver El Study Required El Waiver
CRITICAL AREAS #: DETERMINATION: Conditional Waiver Study Required E] Waiver
DISCRETIONARY PERMIT #'S:
DRAINAGE PLAN DATED:
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORD FOR:
PERMITS (OTHER — list permit #'s): —0 -7
PLANNING DATA CHECKLIST DATED:
SCALED PLOT PLAN DATED:
SEWER LID FEE $:
LID #:
SHORT PLAT FILE:
LOT:
BLOCK:
SIDE SEWER AS BUILT DATED:
SIDE SEWER PERMIT(S) #:
GEOTECH REPORT DATED:
STREET USEJENCROACHMENT PERMIT #:
FOR:
WATER METER TAP CARD DATED:
OTHER:
L:\TEMP\DST's\Forms\Jana's Street File Checklist 5-14-08.doc
Side Sewer Drawing
The Cfty of Edmonds EASEmENT NO - --------- -- -------------------------------
105-09000 NEW CONSTRUCTION REPAIRS LID NO - ------------------ - ASmT. NO - -------------
OWNER ------ D014ALD --- J.----LEWIS ----------------------------------------------- CONTRACTOR ------------------------------------------------- ---------------------------------- PERMIT NO - --------------------
JOB ADDRESS ----- ..560-HEMLOCK—WAX ----------------- ------------------ LEGAL DESCRIPTION: LOT NO - -------------------------------------- BLOCK NO - ------------------------------------
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NAMEOF ADDITION -------------------------------------------- ................. ........................................................
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DYE TESTED ON SEWER
Approved:
PWW-0001-11M (REV.11/78) DATE -------------------------------------------- By ---------------------------------------------------
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SNOHOMISH COUNT , ASHINGTON
Document Title(s)
Reference Number(s) of Related Document(s)
Grantor(s) !nda A Ge
Grant (s)
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Additional Reference #'s on Page
Additional Grantors on Page
Additional Grantees on Page
Legal Description (abbreviated form: ie Lot/Block/Plat or Section/Township/Range)
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Complete Legal on Page
Assessor's Property Tax Parcel/Account Number
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Additional Parcel #'s on Page
The Auditor/Recorder will rely on the information provided on this form, The responsibility for the
accuracy of the indexing information is that of the document preparer.
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0 1 REET FILE
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Return Recorded Instrument To:
City of Edmonds — Clerk's Office
121 51h Ave. N, Edmonds, WA 98020
ACCESSORY DWELLING UNIT COVENANT
Property Address: 560 Hemlock Way, Edmonds Washington
Assessor's Parcel Number: 27032500210100
SEC 25 TWP 27 RGE 03 RT-14) BEG SWI/4 NW1/4 NWIA TH
Legal Description: N ALG W LN SD SUB 396FT TH E 392.98FT TO TPB TH
CONT E 110.02FT TH N TO S LN HEMLOCK ST TH W
110.02FT TH S TO POB
Grantor: Property Owner Pamela A. Axelson
Grantee: Citv of Edmonds
Related Permit Numbers: PLN20110025 & BLD20110734
1, the undersigned, have attained approval for an Accessory Dwelling Unit (ADU) at the property address
above, in accordance with the provisions of Chapter 20.21 (Accessory Dwelling Units) of the Edmonds
Community Development Code (ECDC).
I agree and understand that it is my responsibility to notify all future property owners or long-term lessors of
the existence of the ADU and that its existence is predicated upon the occupancy of either the ADU or
primary dwelling unit by the owner of the property.
Additionally, I will notify all prospective buyers of the limitations on use and maintenance of the ADU as
stipulated in Chapter 20.21 (Accessory Dwelling Units) of the Edmonds Community Development Code. An
example of the limitations of the ADU per Chapter 20.21 is the property owner is required to reside in the
primary or accessory dwelling unit for 6 months out of every year.
Finally, this covenant shall be recorded in order to notify all current and future property owners that if any
conditions of the ADU approval are violated, the property owner will be required to remove all improvements
which were added to convert the primary dwelling unit into an ADU and restore the site to a single-family
dwelling unit.
On my oath, I certify that I reside at 560 Hemlock Way, Edmonds Washington, in the primary or
accessory dwelling unit for morp than six months of every year.
OWNER/GRANTOR: Pdm6WA.
SIGNATURE:
DATED this _2711-1- day of September, 2011
On this day personally appeared before me Pamela A. Axelson, to me known to be the individual
described therein and who executed the within and foregoing instrument, and acknowledged that he
signed the same as his free voluntary act and deed, for the use and purposes therein mentioned. Notary's
K(�.ssure seal must be smudged.
Notary Public Dated:
State of Washington Sign re of Notary Public:
AARON CRUZ WEBSTER
My Appointment Expires Doe 14, 2012 Residing At:
ppointi-nent Expires: xrz_ MOR
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THIS DOCUMENT MUST BE RECORDED WITH THE SNOHOMISH COUNTY AUDITOR -
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Other
Height Z- 5 1'7-
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APPRO17D BY PL�NNING
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5�0 14&Y110cK VJOII/" Nbu- revoodij A--:- ;-;!L� RECEIVED
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DEVELOPMENT SERVICES CTR-
STREET FILE CI1Y OF EDMONDS