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BLD1994-0288 LEGAL DOCSFile No Applicant 4e67461 AFFIDAVIT OF MEADOWDALE LANDSLIDE PERMIT POSTING STATE OF WASHINGTON ) ) ss. COUNTY OF SNOHOMISH ) U being first duly sworn, on oath, deposes and says: That on the day of 19'k� the . site located at �(` �� Q�,� �j(p �r was posted as prescribed by Ordinance No. 2661 on the subject property. This posting begins on the day the City accepts the permit application for review and shall remain until building occupancy is,grahted. Signed Signed Subscribed and sworn to before me this /Sf- day of 19-*. DONNIC E, W IR.T Vtary Public in and for the State of Washington. Residing at SNoH,�mist�4h CITY COPY BUILDING MAR 311994 March 30, 1994 Building Official City of Edmonds Subject: Applicant and Owner Landslide Acknowledgment Declaration Butterfield Design Group 400 Dayton Edmonds, Washington 98020 206-775-0564 We, Thomas and Marilyn Degan, acknowledge the accuracy of all permit submitted information and in a form which relieves the city and its staff from any liability associated with reliance on such permit application submittals. While an application may reference the reports of prior public consultants to the city, all conclusions shall be those of Thomas and Marilyn Degan and their design professionals and consultants. We, Thomas and Marilyn Degan, understand and accept the risk of building our residence in the Meadowdale Slide Area which is an area with potential unstable soils. We will advise, in writing, any prospective purchasers of our residence or any prospective residential leasees of our residence or portions of our residence, of the slide potential of *t,;o araa I state that T o as and :Marilyn Degan have sworn before me this of30t D of March, 199A4. DONNA E. WIRT Snohomish County State of Washington Exp 1-4-98 Flu a - y � Bune&ld Design Group 400 Dayton fdtnonds, Washington 93020 206-775.0564 February 18, 1994 STATEMENUDECLARATION OF THE FOUNDATION DESIGN AT 155200-75TH PL. SW . TO: Building Official Edmonds Planning Dept. The Foundation Design, Plans, and Specifications for the new residence at 155200-75th Place SW have not been modified in any way once they were submitted and plan checked as the "Chwowetli Residence". Signcd Robert Butterfield Architect Butterfield Design Group 400 Dayton Edmonds, Washington 98020 206.775-0564 February 18, 1994 STATEMENT/DECLARATION OF THE FOUNDATION DESIGN AT 155200-75TH PL. SW TO: Building Official Edmonds Planning Dept. The Foundation Design, Plans, and Specifications for the new residence at 155200-75th Place SW have not been modified in any way once they were submitted and plan checked as the "Chynoweth Residence". Signed Robert Butterfield Architect rZE, IVED PEAR a 1 110,94 PER101T CITY V- �thc.1s9v CITY OF EDMONDS 121 5TH AVENUE NORTH • EDMONDS, WA 98020 • (425) 771-0220 • FAX (425) 771.0221 DEVELOPMENT SERVICES DEPARTMENT Planning • Building • Engineering April 9, 1999 Dr. & Mrs. Degan 15520 751h Place West Edmonds, Washington 98026 RE: Homeowner Insurance Coverage for Meadowdale Development fO2, 8-F BARBARAFAHEY MAYOR As you may recall, development of your home was subject to Edmonds Community Development Code (ECDC) Chapter 19.05.050 which regulated construction and insurance coverage requirements for all designated Meadowdale Landslide Hazard Area development. The purpose of this letter is to inform you that the Edmonds City Council has enacted a change which effects your homeowners policy that was required by this ordinance. If you recall you were required to post a one million dollar homeowner policy in order for your home to be granted final occupancy. Please be advised, the City Council has repealed this requirement effective April 16, 1999. In lieu of this policy the City Council will be holding future public hearings to determine alternate coverage methods to ensure that the intent of ECDC 19.05.050 are still met. Please -contact the City Clerk if you are interested in attending these meetings. You may wish to consult your insurance professional to determine the proper amount of insurance coverage necessary to meet your specific needs. Since the insurance requirement is repealed the City no longer requires to be informed of your coverage or be provided with a copy of your current policy. Please feel free to contact me if you have any questions at 771-0220. Thank you, Jeannine L. Graf Building Official Incorporated August 11, 1890 Sister City - Hekinan, Japan CERTIFICATE OF INSURANCE ISSUE DATE (MWDD/YY) MAY 18 96 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND INSURANCE SERVICES GROUP, INC. CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE P.O. BOX 33747 DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE SEATTLE, WA 98133-0747 POLICIES BELOW. PHONE: 206-367-0666 FAX: 206368-7003 COMPANIES AFFORDING COVERAGE COMPANY A CONTINENTAL CASUALTY CO 8 INSURED COMPANY + i3 DR. THOMAS AND MARILYN DEGAN B (CNA INSURANCE CO) 'W4 }' COMPANY S 16620 - 76TH PL W C EDMONDS, WA 98026 COMPANY D COVERAGES THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. Col TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS LTR DATE (MM/)D/YY) DATE (MM/DDNY) GENERAL LIABILITY GENERAL AGGREGATE $ 600,000 COMMERCIAL GENERAL LIABILITY US000260331 MAR 22 95 JUL 25 96 PRODUCTS-COMP/OP AGG. $ LAIMS MADE � OCCUR. PERSONAL & ADV INJURY $ A OWNER'S & CONTRACTOR'S PROT. EACH OCCURRENCE $ 600,000 X US000250331 FIRE DAMAGE(Any One Fire) Is MED. EXPENSE(Any One Perso $ DMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS COMBINED SINGLE LIMIT $ BODILY INJURY (Per Person) $ BODILY INJURY $ (Per Accident) PROPERTY DAMAGE $ GARAGE LIABILITY ANY AUTO AUTO ONLY - EA ACCIDENT $ OTHER THAN AUTO ONLY: EACH ACCIDENT $ AGGREGATE $ A EXCESS LIABILITY UMBRELLA FORM x OTHER THAN UMBRELLA FORM MAR 22 95 JUL 2b 95 EACH OCCURRENCE $ AGGREGATE $ EXCESS LIABILITY 500000 WORKER'S COMPENSATION AND EMPLOYERS' LIABILITY THE PROPRIETOR/ INCL PARTNERS/EXECUTIVE OFFICERS ARE: REXCL STATUTORY LIMITS EACH ACCIDENT DISEASE -POLICY LIMIT Is DISEASE -EACH EMPLOYEE Is OTHER /// l _ d'Y14 7,,/J 'e O" DESCRIPTION OF OPERATIONS/LOCATIONSN ICLES/SPECIAL ITEMS L RE: VERIFICATION OF INSURANCE REGARDING SINGLE FAMILY OWNER OCCUPIED DWELLING AT 16520 76TH PL W, EDMONDS, WA. CERTIFICATE THE CITY OF EDMONDS COMMUNITY SERVICES DEPARTMENT 260 - 6TH AVE NO EDMONDS, WA. 98020 Attention: CANCELLATION j SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 45 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT AILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF& KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. 4UTH ED REPRESENTATIVE i 4�15/94 16:30 1&206 778 6746 BENNETMENNETT 4 002 742 F'61 APR 14 194 14, 46 City of Edmonds Earth Subsidence Landslide Performance Bond Page TWO 3) In the avant the Prill6 pal fails to complete any of the above repairs or restorations within the tiros period specified by the City, Its employees and agents shall have the rignt at their sole olection to enter onto said property for the purpose of completing the repairs. This provision shall not be Construed as creating an obligation on the part of the City or its repre3entative9 to complete such repairs or restorations. r,� '�Z �C 4) in the event any lewsujt is instituted by the City, the Principal or the Surety to enforce the term of this bond or to detaymine the rights of any party hereunder-, the prevailing party in such litigation shall be entitled to recover from the hairs party its costs, Including r4asonable attorneys' raos, incurrac as a result of such lawsuit_ 5j This bond shall remain in full force and offoct until occupancy of the structure is granted and written notification of bond release is issued by the City. at.IF E�ti "vim .w04MM+nOF4. WwuOC#WW%urif�ewo. the •ly how the corporation that MOM i fore9�io 'ism nstirumerrt, and acknowledged the said instrument to be the free and voluntary act and deed of said corporation, for the uses and purpowas therein mentioned" and on oath stated that was autherizect ten exacute said instrument and that tha seal affixed it the corporate soai of said corporation. WITNESS my hand and official seal hereto affixed the day and year first above written. NOTARY m and for heState o kashinaton. residing at 4i15r94 16:29 0208 778 6746 BENNETT&BENNETI' [�j001 13ENNinTT do 33ONNETT ArV0f4ff%V& AT LAW 400 D^rrvn, Owrm A zDm(wDe' WANUIjoavow 96000 (1") P964130 f PAX (2") 77/-610 Onsoraw R. BCNns" (so"? P ftcst W. BlNgQ'rw E" TI MSMiSSint9 LNIGH P. Bappeaw DATE: % 'l TIME: 7 FROM; ' NO. OF PAGES SENT (cxtluding this page) � MESSAGE: i a`Fu ti - This facsimile message is attorgey privileged and confidential and is intended solely for the use of the Individual named above. If you are not the intended recipient. you are haraby advised that any disseatoation, distribution. or copying of this communication is prohibited. If you have received this FAX in error, please immediately notify the sender by telephone and return the original PAX massage to the aender by V. S. Mail. 04-14-1994 02:36PM FROM TKW TO 7710221 P:01 y ' �' S < � _ � � "' � �'. �„� � �' " '` , , # •I DATE (Mn1/fJLYYI'? 01/20/94 ..nv.a K•... M". i<ttf.:1::. PRQDUCER :..a..r :,..)..,.., •?ri INSURANCE RESOURCES 6 SERVICES INC THIS CERTIFICCATE IS ISSUED AS A NATTER OF INFORMATION ON1Y AND 15400 SE 30TH PLACE #103 CONPERSNORIGHTSUPON THE CERTIFICATEHOLDER. THIS CERTIFICATE DOES BELLEVUE, WA 98007 NOTAMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. coot 8590-40 SU&CODE INSURED �;<,a:;.;.:,y:r:.; . .' J• ';':r TRYG WIN U I ST CONSTRUCTION CO. :, ..;>: :" .e:<' '°:': •„;;; CIJMDANY LETTER A NORTH PACIFIC INSURANCE COMP' j839 W MARGINAL WAY SW SEATTLE, WA 981UTY ®ty y COMPANY ANY tt.. - =LETTER B OREGON AUTOMOBILE INSURANCE COMPANY r. ....:: •:. oh :r :c::o:'c': •.::Y �: ...�. ......:E':a :-' y' 'r � a.:.., �', ,: . - .?;'R,:..o- .i:.>. a .. %'.P•i •� r a :.i S ',: b•t:::•4:;1:';^.:°n:: )'�d ;i !ti:��ii>tiiY i L e THIS IS TO CERTIFY TFLAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMEDABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITnN OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THISCERTIFICATE MAY BE ISSUED ORMAY PERTAIN, THE INSURANCEAFFORDED BY THE POL 0ES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONSAND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. a° TtTEofINs~cE FMCYNUMasR ►0UCYE"*CTr4 FaLtCyooWTON OR a+Te(>wwoa*+v Te(Mwvart» Lu�ITs CiNERAL LMBILITY 00' E AGCRECATE s 2,000,000 10 C0MWJRCKc9NER1LLtMILIT1 PitOL)UCf3.CDMP/QPACGr $ 2,000,0()o A 13 QAIM3MA1x M 000A CO2 123085 01 / 14/94 01 / 14/95 1000 000 PERSdNAI.B ADV. IN UQY S OVtA�ER'�dtCbNrMCTOR'SwtpT. Fo"OCCLARENCE $ 11000,000 FIRE0AIw10E(MyonefNel E 50,000 AUTI,wTosuEUABlurr MEO. EXPENSE (Myone perm) $ 5.0001 caunrNip AWAUTO SINCLEUHT ; ALLOWNEDAUTOS aoatY ❑ SDiEDULEDAUTQs Nllxtv(aerpaRanl S Q HIREOAUTOS 6OOILY [j NON-OWNEDAUT06 INIURY(PcraccldwW $ CMACE LIAEIILITY r7 fhROroen Li _ 0/VvV�Gs EXCESSLIABILITY i EntrlOCCURRENCE s OTHER AGGREGATE S STOP GAP 1,000,000. i i DESCRIPTIONOF QCA IO IAL ITEMS �. 1eA %lo st �f enn a. dp; F. 7 7 '" - iM3 wvimw =gt CO, De", now- 00) 937'-111 a FAX 7 7 / - } L,�� 141X •) 937J40 lEl, .1.1.. ,p; . i:;, a.. a..:.v.a ::.: ::.s.A•:.s:.r •: ,. ' ;,N; is .l::.r S i:S. SHOJADANYOFTHEABOVEDF ia! PQi InFcpErANCcl I Tnac ^RETHE' a 1 s EXPIRATK)NDATETHEIWF,THEISSUINCCOMPANYWiLLENpp,AVORTOMAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO STATE OF WASH I NGTON E"'? 1HE LEFT, BUTFAILURE TO MAIL SUCH NOTICESHALL IMPOSE NOOSLIGATION DEPARTMENT OF LASOR AND INDUSTRIES £' PO BOX 44450 OR LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR OLYMPIA, WA 98504-4450 REPRESENTATNES. '; AUTHOII ATIVE ... . .:::.v:..:>.: y.: .. v::,..oy;t<.:: <t:..v..a,t•;:'•::.. .:':•... .Y,., yN.:v::>..:' :.,r ..: ..... n ..•:: iiy. )..,.. ). .. .. w; .. .>:L>:<.yN:: ..:•;::n ::n..a.��:::.y ..:. •.: n:iiiyUi:.fay.:..a .. ....... ........,..,... ...... ..:.:,:.....,:.y.•,•>..... .... :....:,::.,::: y:.,::>:..a,...e.y ir. ...... . ..„.. y.. )...... ,'.<,•:<t;;rt ):ifi:i :S:iS• r; is CS554 9- t 90> ORIGINAL TOTAL P.01 CITY CLERK CIVIC CENTER � �®�� EDMONDS, WA 98020 COVENANT OF NOTIFICATION AND INDEMNIFICATION/HOLD HARMLESS Under the review procedures established pursuant to the State Building Code, incorporating amendments promulgated by the City. of Edmonds, and as a prerequisite, to the issuance of a building periftit for the construction of a residential structure and attendant facilities, the undersigned OWNERS of property do hereby covenant-, stipulate and promise as follows: 1. escrr' r`%..icn C. j r'Dpa r . vanant o notification and indemnification/hold harmless relates to a tract of land at the street address of �S pI AGE W. IS laS S w. ( insert street address), Edmonds, Snohomish County, Washington and legally described as: Tract 1, LUND'S MEADOWDALE TRACTS, according to the pla,: thereof recorded in Volume 6 of Plats, Page 26, records of Snohomish County, Washington, lying Westerly of the,g26isting county road forty feet (40') in widtli (not a dedicated road); less the noi'g ten4eet (10') thereof. Situate in the County of Snohomish, State of Washington. :1�; A �F- m �C7 o 2_ Notification and Covenant of Notification. -fihe above referenced site (hereinafter "subject site") lies within an area which has been identified by the City of Edmonds as having a potential for earth subsidence or landslide' hazard- The risks associated with development of the site have been evaluated by technical consultants and engineers engaged by the applicant as a part of :.lie. process to obtain building permit for the :subject site. The results of the cor :ss , i �.ant's reports and evaluations of WSS52079A/0006.040.034 -1- 1.SS/klt 02/08,90 Yoi. 2915 PAGE 14'74 s the risks associated with development are contained in building permit file number4(insert number) on file with the City of Edmonds Building Department. Conditions, limitations, or. prohibitions on development may have been imposed in accordance. with the recommendations of the consultants in the course of permit issuance. The conditions, limitations, or prohibitions may require ongoing maintenance on the part of any owner or lessee or may require modifications to the structures and earth stabilization matters in order to address future or anticipated changes in soil or other site conditions. The statements and conditions proposed by the OWNERS' geotechnical engineer, geologist, architect and/or structural engineer are hereby incorporated by reference from the contents of the file as fully as if herein set forth. Any future purchaser, lessee, lender or any other person acquiring or seeking to acquire an interest. in the property is put on notice of the existence of the content of the file and the City urges review of its contents. The file may be reviewed during normal business hours or copies obtained at. the Planning Department, City of Edmonds, 505 Bell Street', Edmonds, Washington 98020. 3. Indemnification and Hold Harmless. The undersigned OWNERS hereby waive any and all liability associated with - development, stating that they have fully informed themselves of all risks associated with development of the property and do.' therefore waive and relinquish any and all causes of action against the City of Edmonds, its officers, agentt and employees WSS52079A/0006.040.034 -2- WSS/k1t 02/08/90 0,105230098 VOL. 29.15PAGE14'75 arising from and out of such development_ In addition, the OWNERS on behalf of themselves, their successors in interest, heirs and .assignees, do hereby promise to indemnify and hold harmless the City of Edmonds, its officers, agents and employees from any loss, claim, liability .or damage of any kind or nature to persons or property either on or off the site resulting from or out of earth subsidence or landslide hazard, arising from or out of the issuance of any permit(s) authorizing development of the site, or occurring or arising out of any false, misleading, or inaccurate information provided by the OWNERS, their employees, or professional consultants in the course of issuance of the building permit_ 4. Insurance Requirement.- In addition to any bonding which may be required during the course of development, the Community Services Director has/has not (strike one) specifically required the maintenance of an insurance policy -for public liability coverage in the amount and for the time set forth below in -order to provide for the financial responsibilities established through the indemnification and hold harmless agreement above: [insert insurance requirements and time period, if any --if no insurance required, so state_) WSS52079A/0006.040_034 -3- WSS/klt 02/08/90 - 9405230098. von.2915puE1476 5. Covenant to Touch and Concern the Land_ This covenant of notification and indemnification/hold harmless touches and concerns the subject tract and shall run with the land, binding, obligating and/or inuring to the benefit of future owners, heirs; successors and interests or any other person or entity acquiring an interest in property, as their interest may appear_ This provision shall not be interpreted to require a mortgagor or lender to indemnify the City except to the extent of their loss nor to obligate such persons to maintain the insurance above required. DONE this �_ day of O( 11 199�1% �. i•`+'E:.. ��9 OWN J V. By: By: STATE OF WASHINGTON ) ) ss: COUNTY OF fi) I certify that I know or have satisfactory evidence that A �f signed this instrument and acknowledged' WSS52079A/0006.040.034 -4- WSS/klt 02/08/90 230 VOL. 2 915 PAGE 14'7 7 it to be (his/her) free and voluntary act for the purposes mentioned in this instrument. DATED this ?!6j( day of199 y Y PUBLIC hmi-ssion expires: STATE OF WASHINGTON ss: COUNTY OF ) I certify that I know or have satisfactory evidence that signed this instrument and acknowledged it to be (his/her) free and voluntary act for the purposes mentioned in this instrument. DATED this day of 199__ NOTARY PUBLIC My commission expires: STATE OF WASHINGTON ) ss: COUNTY OF ) I certify that I know or have satisfactory evidence that signed this instrument, on oath stated that (he/she) was authorized to execute the instrument and acknowledged it as the (title) of (name of party on behalf of whom instrument was executed)- to be the free and voluntary act of such party for the uses and purposes mentioned in this instrument. ._ DATED this day of , 199_. NOTARY PUBLIC My commission expires: WSS52079A/0006_040.034 -5- WSS/k1t 02/08/90 94023009 voL. 2 915 PAGE 14 7 8 E WESTERNTI'IE COMPANY OF WASHINMN, INC. LYNNWOOD OFFICE SEATTLE OFFICE BELLEVUE OFFICE FEDERAL WAY OFFIC "n 188th St. S.W., Suite 300 600 University Street, Suite 2428 411 - 108th Avenue N.E. 1230 South 336th Street Lynnwood, WA 98037 Seattle, WA 98101 Bellevue, WA 98004 Federal Way, WA 98003 771-3031 / 527-1432 682-6006 453-8070 874-5115 Fax:527-9240 Fax: 682-3605 Fax: 453-0136 Fax:527-8983 FILED FOR RECORD AT REQUEST OF WHEN RECORDED RETURN TO Name City Clerk City of Edibfids Address 505 Bell Street City, State, zip Edmonds, WA 98020 9 QUIT CLAIM DEED THIS PaCE PROVIDED FOR RECORDER'S USE: f MAY 23 A10 :33 TUR t,ttt,LLiUi_f' ulL� I )MIST{ C'ILINT ?`,,. . 0 THE GRANTORS, THOMAS DEGAN and MARILYN DEGAN, husband and wife, W Cq for and in consideration of dedication to public Mconveys and quit claims to the CITY OF EDMONDS, the following described real estate, situated in the County of State of Washington, including any after acquired title: use, a municipal corporation, Snohomish, The Easterly ten feet (10') of the following described parcel: Tract 1, LUNWS MEADOWDALE TRACTS, according to the plat thereof recorded in Volume 6 of Plats, Page 26, records of Snohomish County, Washington, lying Westerly of the existing county road forty feet (40') in width (not a dedicated road); less the North ten feet (10') thereof. TOGETHER WITH the right to make all necessary cut or fill slopes on the land of grantor's adjacent to the above -described real property in connection with the construction, maintenance or improvement of the above -described real property for purposes of a public roadway. NO EXCISE I DUE $2.00 TreasureC3 Fee Required MAM 1994 Dated %ram/,/i,�!`ii�%_ • By MRKE lI homihomi }Coudy ireasur By Deputy, MA'SN AN ' ' (h�livZluy►7 ) (President) By s (Secretary) y 141IYf *XACKWbWLFSDGEMENT FORM: REPRESENTATIVE ACKNOWLEDGEMENT FORM: cafe of .V4 p,' •' ::..: `i �4 State of WashinSS.gton l Co 1, ISH County of J I certify that I know or have satisfactory evidence that I certify that I know or have satisfactory evidence that _ Thomas Degan and Marilyn Degan signed this instrument, signed this instrument, and acknowledged it to be (his / her) on oath stated that (he / she) was authorized to execute the instrument free and voluntary act fQr the uses and purposes mentioned and acknowledged it as the in the instrument. of to be the free and C y appolrtrrreent expires t DOLPB-12 I"ORIGINAL L-16/WA/9.88 LPB-12 voluntary act of such party for the uses and purposes mentioned in the instrument. Dated Notary Public for the State of Washington My appointment expires + VOL. 2 915 PAGE 14 8 0 J STATEMENT ON ACCESSORY UNITS Property Address 15520 75th P1. W. , Edmonds, WA 98026 Legal Description : That portion of Lot 1 of Lunds Meadowdale Tracts as recorded in Volume 6, Page 26, Records of Snohomish County Washington, described as follows: All of Lot 1 of said plat, except the North 10 feet thereof lying West of the existing County Road and except that portion of said County Road. I have read the requirements for accessory units contained in Chapter 20.21 of the Edmonds Community Development Code and understand that an accessory unit, including a second kitchen, is prohibited for at least two years after occupancy by the current owner is granted and until after a Conditional Use Permit has been approved by the City of Edmonds Hearing Examiner. I also understand that approval of a Conditional- Use Permit is subject to a public hearing, and neither this statement nor the issuance of a permit shall act to limit the discretion of the City in the review of any application for a Conditional Use Permit. Property Owner Name Date NN STATE OF WASHINGTON) COUNTY OF SNOHOMISH) I certify that I know or have satisfactory evidence that /Inv L v c,-R-Y�K— signed this instrument and acknowledge it to be (his/her) free and voluntary act for the uses and Purposes mentioned in this instrument. Dated , Z Signature o Notary Public �-- LL, (Seal or Stamp) Title My appointment .Expires 2-— 5--�= THIS DOCUMENT MUST BE RECORDED WITH THE SNOHOMISH COUNTY AUDITOR KC*lF�Y�