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BLD1997-0555 LEGAL DOCSV 4 05/29/1998 09:56 4253168490 SINEX PAGE 01 4. Silver Lake Insurance NURTIHSOVNb INSURANCE GROUP 10524 32nd DR BE, Everett, WA 99200 1-800.742-9958 / BB NFJCSJDGG'TE.NET Tel (425) 338-5533 Fax (425) 316-8490 FAX 425-771-0221 Tel (425) 771-0220 ATTN: Ms. Graf City of Edmonds pages including oover = A Date: 5/29/99 ICE: Join Young Thank you fbT your assistance. I have attached the Certificate and will sad the original is the nail today, Sincerely, AgenVBrdwW0 mer cc W Jolla Young .PITODUCEA:::::..................................................................................... ..................................................................................... Northsound Ins Grp / S Sinex C/0 10524 32nd DR SE Everett WA 98208 INSURED John P And Lynne L. Young 16123 N Meadowdale Rd Edmonds WA 98020 DATE M/DD "14O S 2 9 9 8 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. COMPANY Q A CNA COMPANY I COMPANY C �YY COMPANY D 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. ICO LTR I TYPE OF INSURANCEI POLICY NUMBER I DATTEPOLICY(MWOD/YY)EFFECTIVE I DATEY (MM/DDIYY) EXPIRATION I LIMITS GENERAL LIABILITY GENERAL AGGREGATE $ COMMERCIAL GENERAL LIABILITY PRODUCT'S - COMP/OP AGG $ CLAMS MADE OCCUR PERSONAL 8 ADV INJURY $ OWNER'S & CONTRACTORS PROT EACH OCCURRENCE $ 5 0 O O O O A CompPe r s L i ab 0 6/ O 1/ 9 8 0 6/ O 1/ 9 9 FIRE DAMAGE (Any one fire) $ MED EXP (Any one person) $ AUTOMOBILE LIABRRY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS COMBINED SINGLE LIMIT I $ BODILY INJURY $ (Per person) BODILY INJURY $ (Per accident) PROPERTY DAMAGE IS AGE LIABIM ANY AUTO AUTO ONLY - EA ACCIDENT $ OTHER THAN AUTO ONLY: — q EACH ACCIDENT $ AGGREGATE $ A EXCESS LIABILITY UMBRELLA FORM OTHER THAN UMBRELLA FORM 0 6/ O 1/ 9 8 0 6/ 01 / 9 9 EACH OCCURRENCE $1 0 0 0,000 AGGREGATE $ $ COMPENSATION AND EMPLOYERS' LIABILITY THE PROPRIETOR/ INCL PARTNERSIEXECUTIVE OFFICERS ARE: EXCL STAWORKERS T RY LIMITS O R — EL EACH ACCIDENT S EL DISEASE - POLICY LIMB $ EL DISEASE - EA EMPLOYEE IS OTHER DESCRIPTION OF OPERATIONS/LOCAMONS/VEHK LESISPECIAL FTEMS Single Family home located at 16123 N Meadowdale Rd, Edmonds, WA 98020 City contact Jeannie Graf - tel (425) 771-0220 fax (425) 771-0221 Insurance Rent - tel (425) 338-5533 fax (425) 316-8490 -- -- ............................... .................. City of Edmonds SHOULD ANY OF THE ABOVE DE..SC. RI..B...... ED POLIC...... S IEBE CANCELLED BEFOR.........E THE..,. Building Department EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 250 5 th Ave N 45 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SMALL IMPOSE NO OBLIGATION OR LIABILITY Edmonds, WA 98020 OF ANY KIND U TH MPANY, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPR f 05/26/1998 15:48 4253168490 SINEX PAGE 01 Silver Lake Insurance NORTHSOUND I NSMANC>E GROUP 10524 32nJ DR 5E, EYerett, WA 96208 14BO I42-OM / SINEXSJDQGTE.NET Tel (425) 338-M Fax (425) 3154349U FAX 425-771-0221 Tel (425) 771.0220 ATTN: Ms. Graf City of Edmonds pages including cover = 1 Date: 5/26/98 RE: John Young Thank you for your reply. I can change the premature cancellation wanting to 45 days. However, I cannot change the industry standard wording on the Certificate. Depending on ronowal dates, if the policy is paid for at renewal, and other factors, a 45 day warning maybe impossible and actually place the insuring company/agcut in a position to provide overage without compensation or be liable to the certificate holder for coverage. The ACQRD Certificate ad its wording, is in industry standard that all insurance companies and agents understand and effectively operate with. Please accept a Certificate with standardized wording. Sincerely, &M Aaatt/nrekw/dwwr cc Mr. John Young Inc.1890 CITY OF EDMONDS BARBARA FAHEY MAYOR 121 5TH AVENUE NORTH • EDMONDS, WA 98020 • (425) 771-0220 • FAX (425) 771-0221 COMMUNITY SERVICES DEPARTMENT Public Works • Planning/Building • Parks and Recreation • Engineering • Wastewater Treatment Plant May 26, 1998 Silver Lake Insurance Mr. Stan Sinex 10524 32°d Dr. SE Everett, WA 98208 Re: Robert Young @ 16123 N Meadowdale Road, Permit #970555 Meadowdale Insurance Requirement I am in receipt of the faxed Certificate of Insurance for Mr. Young and I have listened to your voice mail message regarding why the City of Edmonds cannot be named as an additional named insured on the subject policy. The last revision now requested is on the cancellation notice, please revise that section to read, "should any of the described policies be cancelled before the expiration date thereof, the issuing company will mail 45 days written notice to the certificate holder named to the left." If you have any questions, please contact me at (425) 771-0220. Thank you, 640� Jeannine L. Graf Building Official • Incorporated August 11, 1890 A Sister Cities International — Hekinan, Japan 05/26/1990 12:08 4253168490 SINEX PAGE 01 Silver Lake Insurance NORTHSOUND INSURANCE GROUP 10524 32M OR SE, Everett, WA 98208 1-50D-742-MO / SI NEXSJDGGTE. NET Tel (425) 338-5533 FaX (425) 316-8490 FAX 423-771-0221 Tel (425) 771-0220 ATTN: Ms. Graf City of Edmonds PASO$ including cover = 1 Date: 5/26/99 RE: John Young F��SIVED MAY 2 6 1998 pERMIT COUNTER Per my voice mail today, l have Attached` certificate of insurance example for your rcview. Sincerely, QQ A tUU/LQ/.1; AMV3roker/Owner cc Mr. John Young 5/26/98 The Following is the message left on Jeannine Graf s voice mail From: Stan Sinex/Silver Lake Insurance RE: Insurance/ Adding City of Edmonds as additional named insured The question is adding the Young as additional insured. I don't know of a personnel homeowners company that wants to insure the City of Edmonds. There is specific exclusion that say it's not for commercial use, which the City of Edmonds is classified under. The issue is not so much the provider of the Certificate or the 1 million for the Young's. The issue is adding the City to their policy as an additional insured. If the City researched their policies they would find them to be worthless. Companies would reject the Certificate as we found out with CNA. I don't know of any Insurance Company who does this. Typed off voice mail by Vivienne Myers Ihc.1890 CITY OF EDMONDS BARBARA FAHEY 121 5TH AVENUE NORTH EDMONDS, WA 98020 (425) 771-0220 •FAX (425) 771-0221 MAYOR COMMUNITY SERVICES DEPARTMENT Public Works • Planning/Building • Parks and Recreation • Engineering • Wastewater Treatment Plant May 22, 1998 Silver Lake Insurance Mr. Stan Sinex 10524 32nd Dr. SE Everett, WA 98208 Re: Robert Young @ 16123 N Meadowdale Road, Permit #970555 Meadowdale Insurance Requirement Your fax sent on 5/19/98 was just routed to me from another division. Apparently it was mixed up in another fax so I apologize for the tardy reply. I can fax you several more policies that have been accepted by the City that do not have the exact sample language the City desires on the Certificate of Insurance, but I am confused as to why Silver Lake Insurance and the underwriter will not submit a certificate of insurance. I understand you said that the exact language will not be accepted by the underwriter but again we would like to see what they could provide. I am not an insurance expert so if I have used some terminology incorrectly I apologize. But hopefully you understand that it is my duty to request a certificate of insurance to meet the insurance requirements of Ordinance #2661. Every other Meadowdale homeowner who was subject to this regulation was able to provide some evidence of compliance. If you have any questions, please contact me at (425) 771-0220. Thank you, eannine L. Graf Building Official s Incorporated August 11, 1890 e Sister Cities International — Hekinan, Japan 05/19/1998 11:48 2063168490 SINEX PAGE 01 Silver Lake Insurance NORTESOMD INSURANCE GROUP 10524 32nd DR SE, Everett, WA 98208 1-800.7424M / SINEXSJDQC,TE.NET ,,,,�A Tel (425) 338.5M Fax (425) 31"480 FAX 425-771-0221 Tel (425) 771-0220 ATTN: Ms. Graf City of Edmonds pages including cove' — 1 Date; 5/ 19/98 RE: John Young Thank you for your fax example of a Certificate of Insurance adding the City of Edmonds to a Homeowners policy, We spoke with the insuring cornpany represented of the fax, CNA, and they will not honor such a certificate again on a Homeowners poky. Sincerely, &&, AgmLSro➢arlowow cc Mr, John Young Ihc.1890 CITY OF EDMONDS BARBARA FAHEY 121 STH AVENUE NORTH • EDMONDS, WA 98020 (425) 771-0220 •FAX (425) 771.0221 MAYOR COMMUNITY SERVICES DEPARTMENT Public Works • Planning/Building • Parks and Recreation • Engineering • Wastewater Treatment Plant May 18, 1998 Silver Lake Insurance Stan Sinex 10524 32nd Dr. SE Everett, WA 98208 Re: Robert Young/Insurance @ 16123 N Meadowdale Road We are in receipt of the subject insurance policy. Please see attached sample Certificate of Insurance; the City of Edmonds needs to be named as an additional insured liability for personal injury, death, property damage, and/or loss arising out of the City's involvement in the permitting process in connection with the residence premises. Please be advised the policy must be a minimum of one million dollars & must be maintained continuously for ten years. If you have any questions, please contact the Building Department at (425) 771-0220. Thank you, 6�� Jeannine Graf Building Official • Incorporated August 11, 1890 Sister Cities International — Hekinan, Japan 05/18/1998 13:17 2063168490 SINEX PAGE 01 Silver Lake Insurance NORTHSOUND INSURANCE GROUP 10524 32nd DR SE, Everett, WA 9020a 1-800.742-9%0 / 81 NEXSJDQGTE. NET Tel (425) 338-5533 Fax (425) 31"490 FAX 425-771-0221 Tel (425) 771-0220 ATTN: Nis. Graf City of Edmonds pages including cover — l Data: 5/18/98 RE: John Young T%nk you for your fax requesting a Certificate of hasurance adding the City of Edmonds to the Young's insurance. We spoke wraith the insuring company, and they will not ,honor such a certificate on a Homeowners policy. We de not Imowr of an insurance company that Will. Can you refer us to an insurance company that has already provided the City with such a certificate based on a Homeowners policy? sincerely, 7[)t/T� Atea0raker/Owner cc Mr. John Young it? c.189"1 CITY OF EDMONDS BARBARA FAHEY 121 5TH AVENUE NORTH • EDMONDS, WA 98020 • (425) 771-0220 • FAX (425) 771-0221 MAYOR COMMUNITY SERVICES DEPARTMENT Public Works • Planning/Building • Parks and Recreation • Engineering • Wastewater Treatment Plant May 15, 1998 Mr. Douglas F. Rick, Attorney 8101 Oakes Avenue Everett, Washington 98201 RE: John Young SFR @ 16123 North Meadowdale Road, Permit #970555 The City is in receipt of your letter on behalf of Mr. Young regarding his inability to obtain the exact general public liability insurance policy as required by Chapter 19.05 and City Ordinance #2866, for occupancy approval at 16123 North Meadowdale Road. It is not appropriate at this time to grant a complete waiver since Mr. Young's insurance company has never provided a copy of the type of policy they can provide in an attempt to satisfy this requirement. However, I have instructed the Building Inspector to conduct the final occupancy inspection today since Mr. Young has indicated further delays will create a large financial burden to him. Please note, granting of final occupancy does not alleviate Mr. Young from his obligation to address the insurance requirement until a policy is approved or the requirement is waived by the City. Thank you, Jeannine L. Graf Building Official Cc: John & Lynne Young, PO Box 1374, Edmonds • Incorporated August 11, 1890 • Sister Cities International — Hekinan, Japan SiLVL,. LAKE INSURANCE ST,.. , SINEX (425) 338-5533 x May 15, 1998 2'q B B Mq O ` Y 1 Mr. John Young 80/z 8 �998 .: • , 16123 N Meadowdale RD D�AI Edmonds, WA 98020 FPT Dear Young, Per our discussions and faxed correspondence today T have attached a copy of the Homeowners liability wording that will be part of the actual policy we will be sending to you. The liability limit we agreed to provide you is $500,000 per occurrence. A 1 will also send a copy to Jeannie L. Graf, at the City of Edmonds and, Douglas Ricks, + Attorney. Sincerely, Stan Sinex Agent / Broker/ Owner A part of NORTHSOUND Insurance Group SINEXSJD@GTE.NET 10524 32nd DR SE Everett WA 98208 Tel 1-800-742-9959 FAX 425 316-8490 MEMO TO: Scott Synder, City Attorney FROM: Lara Knaak, Permit Coordinator DATE: May 14, 1998 RE: John Young SFR @ 16123 North Meadowdale Road Meadowdale Landslide Hazard Area Mr. Young's attorney has provided a letter (attached) stating that Mr. Young cannot obtain the general public liability insurance policy as required by Chapter 19.05 and City Ordinance #2866. The letter requests a full waiver from this requirement. My question is since the ordinance provides alternate methods in lieu of insurance such as: bonding, frozen fund,account, letter of credit etc., don't we have to require that he comply or attempt to comply with one of these options before granting a waiver of the entire requirement? Note, all other Meadowdale owners have been able to provide some type of insurance and as you know some had major revisions to the preferred policy language but we did accept those. His insurance agent has not even submitted a revised policy showing what he can provide so we don't even know how watered down the policy is or is not. FRIrN.': DOUGLAS F. RICKS PHONE NO. : 425 252 1681 May. 14 1998 12:26PM P2 r Xkotiglab Vmiiklin Riclr9 AttoraeyrL Law '3101 Oakes Avenue I✓VMM., WashingtOn 9,8201-4471 (206) 252- If.FS 1 May 14, 1998 City Of Edmonds Community Sewices Department Building Planning Engineering 212-6th Avenue North Edmonds, WA 98020 Attn: Jeanine Graf Dear Ms Graf:. BUILDING MAY 14 1998 I represent John Young. He has completed a home in Edmonds and as you are aware needs an occupancy permit. He has tried to obtain the general public liability policy naming the City as an additional insured as requirad by City Ordinance #2866, Chapter 19.05. Mr Young has made superhuman efforts to comply with the section but he can not obtain the insurance. He has sought professional help through the insurance industry and the insurance is not available to him. I have discussed the matter with Mr Scott Snyder and he is aware of the problem and non -availability of the insurance. I believe that Mr Scott Snyder has discussed the matter with you also. Mr Young hereby requests that the requirement be waived and that he be issued an occupancy permit. Thank you for your kindness and consideration in this matter. Sincerely, Dougho F. Ricks cc: John Young fnc.18913 CITY OF EDMONDS BARBARAFAHEY 121 5TH AVENUE NORTH - EDMONDS, WA 98020 • (425) 771-0220 • FAX (425) 771-0221 MAYOR COMMUNITY SERVICES DEPARTMENT Public Works • Planning/Building • Parks and Recreation • Engineering • Wastewater Treatment Plant May 13, 1998 Mr. Young, Your Insurance Agent, Shan 5inex has informed the City in writing that he is unable to provide the required insurance coverage for your occupancy approval of your home @ 16123 N Meadowdale Road as required by City Ordinance #2866. However, the ordinance does provide alternate means of coverage; "If such insurance is practically unavailable, or the applicant is unable to provide adequate insurance coverage, the applicant may request (in writing) review of alternate methods such as: bonding, frozen fund account, letter of credit, or other proof of financial responsibility that indicates the applicant's ability to fulfill the indemnification agreements with the City and to fulfill the applicant's legal responsibility to neighboring properties." Unless you can f ind an another Insurance Company that can provide the required policy you may want to investigate the alternate methods described above. If I can be of further service please don't hesitate to call me. Thank you, 5 yIiV r �', V ✓ V Lara Knaak Permit Coordinator ® Incorporated August 11, 1890 Sister Cities International — Hekinan, Japan 05/13/1998 07:51 2063168490 SINEX PAGE 01 Silver bake Insurance NORTNSOUND INSURANCE GROUP 10524 32M DR SE, Everett, WA 98208 1-80&742-9959 / SINEXSJDGGTE.NET Tel (425) 338-5533 Fax (425) 318.8490 FAX 1-425-771.0221 ATTN: Ms. Larn Knaak pages including cover = l Date: 5/8/98 RE: Permit # 97055, Dan Young Per our conversation today f have hcch unable to find an insurance carrier who will provide the Young's insurance your require for an occupancy pennit. !have also spoken with State Fanu and Allstate agents in Edmonds who said they will not provide such insurance. Could you please tell the which insurance carrier you have received this type of insurance front? l do not need to know the agent or homeowner, just the Company. l am concerned that if you do have such an indication of insurance that it would in fact provide any protection. Have you contacted the insurance Company (not the agent) to verity that the coverage will apply to your specific needs? l.,astly, i would also like to know if you have reviewed thin insurance requirement with the State Insurance Commissioner, I am concerned that this type ofinsttrance is legal anti/or approved. Sincerely, A6est/drekerlowner cc Dan Young V. � �1 C Insurance •Bonds •Benefits ,AS R I 1800 Ninth :Avenue, Suite 1500 Seattle, Washington 98101 HURLEY, ATKINS & STEWART (206) 68?-5656(� I N C O R P O R A T E D FAX (206) 682-8494 HURLEY ATKINS & STEWART, INC. phone 206-682-5656 fax 206-682-8494 FACSIMILE COVER SHEET DATE: May 28, 1997 4 TO: CITY OF EDMONDS ATTN: Lara Knaak FAX# 7710221 (425) #PGS: 2 RE: EVERGREEN CONSTRUCTION BURDIW6 MAY 2 9 1997 Following is Certificate of Insurance naming the City of Edmonds as Additional Insured as respect to insured's operation at 16123 N Meadowdale Rd. Edmonds, Washington. This Certificate has been issued in accordance with our client's instructions. If after review you require modification to this document, please contact me. V5,�/-n o ! �� L/-,, Vicki Smollen Account Manager cc: Dar. Young Fax #206-367-4387 RETURN ADDRES; City of Edmonds, City Clerk 121 5th Avenue No. Edmonds, WA 98020 9707160501 07/16/97 14:57 p.0005 Recorded Snohomish County UUILUING AUG - 8 1997 COVENANT OF NOTIFICATION AND INDEMNIFICATION/HOLD HARMLESS Reference #: 05 DLD Grantor(s): (1): e/�.v cam, ot,,-,r, (2) krAL r quu-4j & Additional on pg. Grantee(s): City of Edmonds Legal Description (abbreviated): Sec Twn Z 7 Rng A Qtr OR Lot Block Plat S-13 -�F/ Assessor's Tax Parcel ID#(s): (1)�5-133 (2) Assessor's Tax Parcel ID# not yet assigned CITY OF EDMONDS APPROVED FOR RECORDING BY: DATE: PAGE —OF — 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 permit for the construction of a residential structure and attendant facilities, the undersigned OWNERS of property do hereby covenant, stipulate and promise as follows: RETURN ADDRES; City of Edmonds, Ci ty C1 e r k 121 5th Avenue No. Edmonds, WA 98020 APPROVED FOR RECORDING: BY: DATE: PAGE OF 1. Description of Subject Property. This covenant of notification and indemnification/hold harmless relates to a tract of land at the street address of ��o I --), a-, N . k-b (insert street address), Edmonds Snohomish County, Washington and legally described as: �03 /0a32, ZL.�� fN�, 2. Notification and Covenant of Notification. The 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 the process to obtain a building permit for the subject site. The results of the consultant's reports and evaluations of the risks associated with development are contained in building permit file number (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 9707160501 RETURN ADDRESS City of Edmonds, Ci ty C1 e r k 121 5th Avenue No. Edmonds, WA 98020 APPROVED FOR RECORDING: BY: DATE: PAGE 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 rile 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, 250 5th Avenue North, 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, agents and employees 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 9707160501 RETURN ADDRESS: City of Edmonds, Ci ty C1 erk 121 5th Avenue No. Edmonds, WA 98020 APPROVED FOR RECORDING: BY: DATE: PAGE OF 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: 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. 9707160501 RETURN ADDRESS. City of Edmonds, City Clerk 121 5th Avenue No. Edmonds, WA 98020 APPROVED FOR RECORDING: BY: DATE: PAGE OF DONE this day of .r ,-c , 199 �.17 OWNER(S) By: I By STATE OF WASHINGTON ) ss: COUNTY OF ) I certify that I know or have satisfactory evidence thatyJ N AI ) YOaW6-- � yly&jo�/l�c� 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 l - , 199%. NOTARY PUBLIC My commission expires: / - 9 - 0 0 .403 L:\TEMP\BUILDING\MEADOW\COVENANT a e.a�.•• t' v� Wntib 9707160501 1707160502 07/16/97 14:57 p.0001 Recorded Snohomish County Q C� Return Address: City of Edmonds City Clerk 121 5th Avenue No. Edmonds, WA 98020 BU11DING AUG - 8 1997 STATEMENT ON ACCESSORY DWELLING UNITS Property Address: P1a Edmonds, Washington Legal Description: h.0 i r3�'y C-J- W,.. �01-- Assessor's Parcel Number: I have read the requirements for accessory dwelling units contained in Chapter 20.21 of the Edmonds Community Development Code and understand that an accessory dwelling unit, including a second kitchen, is prohibited for two years after occupancy by the current owner (unless a waiver is granted by the Community Services Department) and until after a conditional use permit has been approved by thg 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 building permit shall act to limit the discretion of the City in the review of any application for a conditional use permit. Property Owner Signature: Date: �1►�►+�►aui;;i; " STATE OF WASHINGTON COUNTY OF SNOHOMISH ) � :� 44 I certify that I know or have satisfactory evidence that �(�f'IItJ � �,1,�,��'�-- �-' •,� •�=• signed this instrument and acknowledge it to be his/her free and voluntary act for the uses and' g g y �p�S.+.; mentioned in this instrument. Notary's pressure seals must be smudged. Dated: S - r;? - 17 . Signature of —j Notary Public: Residing at: My Appointment Expires: THIS DOCUMENT MUST BE RECORDED WITH THE SNOHOMISH COUNTY AUDITOR. PLAN CHECK NO.:97-50 APPLICANT: Young AFFIDAVIT OF POSTING MEADOWDALE EARTH SUBSIDENCE PERMIT STATE OF WASHINGTON ) COUNTY OF SNOHOMISH ) I, John Young, first duly sworn, on oath, depose and say: That on the 18th day of Feb., 1997, the attached Notice was posted as prescribed by Ordinance, and where applicable on or near the subject property at 16123 North Meadowdale Rd., Edmonds. Signed Qa�'p ��- Subscribed and sworn to before me this LI�LT=day of 1 , 1921. ' E. ,y fiA.�L� oAR P : r' Not (ry Public in and for the State of Washington. �'' Residing at �,,,;L Au.d, C F ti• Document2 k- -- -_ ), C tLL JOHN & LYNNE YOUNG RESIDENI:r: 161XX NORTH MEADOWDALE ROAD; EDMONDS, WA. LOT 3; EDMONDS SP # 13-91 APPLICANT/OWNER LIABILITY & LANSDSLIDE ACKNOWLEDGMENT THE APPLICANT/OWNER OF THE PROPERTY DESCRIBED AS LOT 3; EDMONDS SP #13- 91 HEREBY ATTESTS THAT: A) THE ACCURACY OF ALL PERMIT SUBMITTAL INFORMATION IS WARRANTED BY THE APPLICANT/OWNER IN A FORM WHICH RELIEVES THE CITY OF EDMONDS 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 OF EDMONDS, ALL CONCLUSIONS SHALL BE THOSE OF THE APPLICANT/OWNER AND HER/HIS DESIGN PROFESSIONALS (ECDC 19.05.030) AND; B) THAT THE APPLICANT/OWNER UNDERSTANDS AND ACCEPTS THE RISK OF DEVELOPING IN AN AREA WITH POTENTIAL UNSTABLE SOILS AND THAT THEY WILL ADVISE, IN WRITING, ANY PROSPECTIVE PURCHASERS OF THE SITE, OR ANY PROSPECTIVE LESSEES OF STRUCTURES ON THE SITE, OF THE SLIDE POTENTIAL OF THE AREA. (ECDC 19.05.040C). DONE THIS T?' DAY OF ) OWNER(S): BY: BY; BY: STATE OF WASHNGTON ) ss) COUNTY OF �S (l o 1'{ �j G I cmrtify that I know or have satisfactory evidence that`' tJ E t�0 U /JG signed this instrument and acknowledged it to be (his/her) free and voluntary act for the purposes mentioned in this instrument DATED this /Q 7-µ day of f' Ef ,. i9 7 �'�pb.Nq••.. i40tAAY PUBLIC LIC �. My commission expires: r y d uB1. o o 61 OF lei FED D ! 0 1°97 (-tgt( 4[-71g3