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19117 OLYMPIC VIEW DR.PDFiiiiiiiiiii 12602 19117 OLYMPIC VIEW DR (7966c-ar8' When. recorded mail to: City Clerk City of Edmonds 121 Fifth Avenue North Edmonds, WA 98020 CONFORMED COPY 200112101018 12/10/2001 04:44 PM Snohomish P.0005 RECORDED County SPACE ABOVE THIS LINE FOR RECORDER'S USE Assessor's Parcel No. JOV.0 Project No. & Name: ENCROACHMENT AGREEMENT ov This ENCROACHMENT AGREEMENT ("Agreement") is entered into between the CITY. OF EDMONDS ("City") and __. TF " /l -7- ;G2,,,, J.- Aikljc o;,,� ("Owner[s]"), in accordance with Chapter 18.70 of the Edmonds Community Development Code. he�Pronerty. Owner is the owner of that certain real property located at within the City of Edmonds, Washington, Assessor's Parcel Number00�.��/�;DaDd /D/ and more particularly described in Exhibit "A" attached hereto and incorporated herein by reference. Business owner, is the business owner of that certain real property noted above. 2. The Easement. The City currently owns an existing easement over, under, and across Owner's property for street, alley, sidewalk, other (. /V//9 ) which is described in Exhibit `S" attached hereto and incorporated by reference. 3.. The Encroachment. The City .hereby covenants and agrees and grants its pernussion to Owner or Business Owner to allow /2n to remain in a portion of the City right-of-way/easement. A plat map showing the location of the encroachment is attached as Exhibit "C" and incorporated by reference. This Agreement is subject to -the following terms and conditions: a. The encroachment shall be installed and maintained in a safe and sanitary condition at the sole cost, risk;and responsibility of the owner and its successors in interest. b. . The Owner shall agree at all times to indemnify and hold the City free and harmless from. any and all claims, demands, losses; damages or expenses resulting from the -1- 0 construction, maintenance, use, repair or removal of the structure installed hereunder, including any loss, damage or expense ,arising out of (1) loss or damages to property and (2) injury to or death of persons. c. The Owner must remove or relocate any part of the encroachment within ten (10) days or such other time as specified in the notice after receipt of it from the City Engineer, or the .City Engineer may cause such work to be done and the reasonable .cost thereof shall constitute alien upon the property. . . d. Whatever rights and obligations were acquired by the City with respect to the easement shall remain and continue in full force and effect and shall in no way be affected by city's grant of permission to construct and maintain the encroachment structure. 4.. Entire Agreement. This Agreement constitutes the entire agreement between the. parties with respect to the subject matter hereof and supersedes and replaces all other agreements, oral or written, between the parties with respect to the subject matter. 5.. Notices. Any notice which is required or may be given pursuant to this Agreement shall be. sent in.writing-by United States mail, first class, postage pre -paid, registered or certified with return receipt requested,. or by other comparable commercial means and addressed as follows:. If to the City: City Engineer City of Edmonds - 121 Fifth Avenue North Edmonds, WA 98020 If to the Owner: which addresses may be changed from time to time by providing notice to the other party. in the manner described above. 6. Waiver. City's consent to or approval of any act or omission by Owner shall not constitute a waiver of any other default by Owner and shallnot be deemed a waiver or render unnecessary City's consent for approval to any subsequent act by Owner. Any waiver by. City of any default must be in writing and shall not be a waiver of any other default concerning the same or any other provision of the Agreement. -2- 7. Successors and Assi M. This Agreement shall be binding and inure to the benefit of the parties hereto and their respective legal representatives, successors, and assigns. Owner agrees to incorporate this agreement by reference in any subsequent deeds to the property, but any failure to do so does not invalidate this provision. 8. Ca aci Each party represents that the person(s) executing this Agreement on behalf of such party has the authority to execute this Agreement and by such signature(s) thereby bind such party. IN WITNESS WHEREOF, the parties hereto have executed this Agreement on this day of , 20 0 I . By: - STATE OF WASHINGTON ) COUNTY OF SNOHOMISH ) This day, personally appeared before me,gJ- to me known to jje. the person(s) who executed the within d foregoing document and that (he/she/they) signed the same as (his/her/their) free and voluntary act and deed for the uses and purposes therein mentioned,,,? CARLA RAY MW~ NOTARY STATE OF C0MPR$1�1 2= 1,yY%.0 ui t-LLULGU INdIIIG My Commission expires: / 3 --6 3 CITY OF ED NDS By: Via / GINEERING DIVISION o:%SHARE,reMP\BLMmi Jcux wnour\Fjcm,d„+v.aa - 3 - EXHIBIT A Legal Description: Edmonds Sea View Tracts BLK 000 D-01— W 150sgft of S % Lot 81 Less N 6ft of W 150ft of Lot 81 & W 1.... 75 Range/Town/Section: R-03E T-27N S 13 — Q SE Parcel No. 4346 000 08101 .SE- ------ ­"YA 44+NYr1 {AR B KEAD 5 4 3 (43 1 2 �XHrair c 13 27 i I L 03 V, 02 +N;rt+� V�1M.1H+H+li 79,1 L31.}s 4-025 20 2 i +�« �4-024 15 4-030 ' 4-026 !f 22 _,t�_,q +!=k.Vh4,B4Yhyff�4fW+H+H�+11 118 ' 4-028 1 4-029 �. , 0^ = o^ 21pj,' A. 4-074 4-125 if �0 . *h 1 7 1TTENDEN'S 6.. 2 q 6 I T/ (4251 003 4 76 02 03 06 S00 #�..7 02 r 02 +H+},+H+,A 02 # SIB S-17.84 + Of `hhY z 031 63 ,�' I 76 # 04 �� 04 _ ' O1 79 = 02 04 II O hYI.Y#m ril r f 02 `�♦ 6 01 A of 03 06 t 8. -2 - t + wN1,02 02 ++HH+HiHi+ Of A 02 0 0 0+ 03 hVAVA"AM+Yh4tH 81 01 py 04 +SH+H+ MZ . I+H+HYhY4; 04 m+rti Yh4hYA{4H+H+H 01 c 0 - 8 @ N 05 06 03 of. 03 � 02 +~h 63 04 � Of + +H}H+HHYfihVhtiFH+H+HVH 04s 02 03 1 h4'r.1H+H _+H+HWW +H+H+I+H+HFr4}++H+Hff+"Yh 02 8401 2 111H4Yh Yh 01 86 02 3 { iHH+H+H+I+H+N Of s A. ._.. 2 08 � 07 4FH+W+W h'�'h4WhYAYrh4h 60 06 1p. � OF ED ti� : Odd St. 1 g9' ENCROACHMENT PERMIT APPLICATION PROPERTY OWNER NAME: Sco-rT 9� �er.v tT �%�+JGgi.� Phone (V215) PROPERTY OWNER MAILING ADDRESS: ! 4/ / 3 GJ.a 99006 BUSINESS NAME for Commerical applications: NA ADDRESS OF PUBLIC USE:f9// :� he' V� 0"'S aq • 7QOed *************************************************************************************** Describe the portion of public space, City right-of-way or easement area to be utilized (i.e., overhead space of sidewalk, 10 foot Citty, utility easement along north property line, etc): / ( iYyJoe Describe the t e of encroachment or use desired (i.e., fence 6 feet by 150 feet, awning 3 feet wide by 7 feet lon,g, etc.): EeY 4�A-OXAllmpr-r">' Z,Z /%• t-l— 65' .>0%Act ^ upm-0 Specify the length of time for use (i.e. awning for life of building, espresso cart for summer months, etc.), NOTE. The issuance of this permit is understood by the applicant to be of a temporary nature and that no vested right is granted. INDEMNITY.• The applicant understands and by his/her signature to this application, agrees to hold the City of Edmonds harmless from any injuries, damages or claims of any kind or description whatsoever, foreseen or unforeseen, that may be made against the applicant or the City of Edmonds, or any of its departments or employees, including but not limited to the defense or any legal proceedings including defense costs, court. costs, and attorney fees by reason of granting this permit. In addition, the application understands that the City shall be provided a Certificate of Insurance to indemnity and hold harmless the City of Edmonds from all claims and/or property damage, and naming the City of Edmonds as an additional insured. CODE APPLICATION.- By signing the application below the applicant warrants that s/he has read or had the opportunity to read Chapter 18.70 of the Edmonds Community Development Code and s/he understands that all terms of the adopted ordinance are incorporated herein as if set forth n�Jis application and permits therefore are subject to the terms of that Chapter. SIGNA OWNER /°/9/o 1 . Encroachho. doc j lg 10/00 CRITERIA OF PERMIT APPROVAL The applicant shall follow the noted conditions on the building permit. For applications that do not require a building permit the following criteria shall be maintained at all times. ➢ Provide safe pedestrian travel for sidewalk encroachments. Maintain a clear zone of 44 inches minimum. See definition of clear zone below. ➢ Exterior light fixtures, banners and flags must be a minimum of 7 feet above City right-of-way. ➢ Maintain clear landings on the, exterior side of all required exit doors of 44 inches or no less than width of door, measured toward the street. ➢ No projections into City alleys are permitted unless the projection exceeds 15 feet above pavement surface. ➢ Do not block illumination from City light fixtures or hang objects from City light standards. ➢ Architectural projections from buildings must be approved by the Design Board and conform to Uniform Building Code requirements. A building permit shall be required for such projections. ➢ Maintain 3 feet of clearance around fire hydrants, standpipes, manholes, water meters, blowoffs, cleanouts and valves. ➢ Bistro dining tables and chairs must be placed in accordance with City Ordinance No. 3293. ➢ Merchandise racks, espresso carts, flower planters, benches must not be located within the "clear zone". ➢ Ramps require a separate building permit and must conform to UBC standards. Clear Zone Definition: Clear Zone refers to an area 7 feet in height and 44 inches in width providing a level, safe walking surface along the public sidewalk (i.e. measuring 44 inches from edge of street tree grates or newspaper stands toward place of business and from the ground up to a height of 7 feet -----------DEPARTMENT APPROVALS ---FOR CITY USE ONLY ------------------- Planning Division Approved By 1, i/ tf-OUKADB# . Date W1 l 0101 Remarks or Comments: c:tz.y44yelz_ s' i,.A pelrlo e-eTTAA,1,e- Public Works Approved By Date //- 29 — o l Remarks or Comments: Engineering Division Approved By Remarks or Comments: SEA CO Certificate of Insurance Verified By Easement Agreement sent. to City C ///30/0l ENCROACHMENT PERMIT# o�OD�-1JD/8 ISSUANCE DATE /l��l RELEASED BY BUILDING PERMIT # �51 Encroachho.docjlgl0/00 November 30, 2001 Engineering Division Comments Newcom Encroachment Permit Application dated 10/9/01, Rev 11/29/01 Approved with the following comments: 1. Rockery construction to be in accordance with revised drawing dated November 29, 2001. 2. Height of the rockery to be limited to one tier of rocks, or 2.5 feet, whichever is less. 3. Maximum horizontal encroachment of rockery into right of way to be limited to no more than 2 feet from the right of way edge. DAVID K. GEBERT, P.E. City Engineer 11/29 .22:42 page 2 METROPOLITAN PROPERTY AND CASUALTY INSURANCE COMPANY ULTRA HOMEOWNERS ..EVIDENCE OF INSURANCE ---------------- ! NUMBER: 534-64-6634-2' TRANSACTION TYPE: POLICY CHANGE POLICY TERM: FROM 04/28/01 TO 04/26/02 TRANSACTION EFFECTIVE: 11/29/01 PROCESS DATE:; 11/29/01 ---------------------------------------------------------------------------- SCOTT.R NEWCOM.AND ERIN J NEWCOM HUSBAND AND WIFE, AS JOINT TENANTS 19117 OLYMPIC VIEW DRIVE EDMONDS WA 98020 ---------------------------------------------------------------------------- THE PURPOSE OF THIS EVIDENCE OF INSURANCE IS TO PROVIDE DWELLING INSURANCE PROTECTION FOR YOUR HOME AT TIME OF CLOSING WITH THE MORTGAGEE LISTED BELOW. ---------------------------------------------------------------------------- BASIC POLICY COVERAGES LIMITS COVERAGE A - DWELLING $302,100 COVERAGE B - PRIVATE STRUCTURES 60,420 ---------------------------------------------------------------------------- REPLACEMENT PLUS COVERAGE APPLIES TO COVERAGE A % YES NO ---------------------------------------------------------------------------- COVERAGE C - PERSONAL PROPERTY $226,575 COVERAGE F - PERSONAL LIABILITY 300,000 COVERAGE G - MEDICAL PAYMENTS TO OTHERS EACH PERSON 1,000 TOTAL PREMIUM: $ 991 ---------------------------------------------------------------------------- THE RESIDENCE PREMISES IS LOCATED AT: 19117 OLYMPIC VIEW DRIVE EDMONDS WA 98020 ---------------------------------------------------------------------------- DEDUCTIBLES: $250 ------------------------------------------------- --------------------------- 1ST MORTGAGEE INFORMATION:. 2ND MORTGAGEE INFORMATION: WASHINGTON FEDERAL SAVINGS ITS SUCCESSORS AND/OR ASSIGNS 425 PIKE STREET SEATTLE WA 98101 LOAN NO. 050-200-2316396 ---------------------------------------------------------------------------- COVERAGES F AND G APPLY TO THE ADDITIONAL INSURED PREMISES, LOCATED AT: 121 5TH AVE NORTH EDMONDS WA 98020 ---------------------------------------------------------------------------- ADDITIONAL INSURED: CITY OF EDMONDS THE DEFINITION OF THE INSURED IS AMENDED TO INCLUDE THE PERSON OR ORGANIZATION SHOWN ABOVE WITH RESPECT TO COVERAGES A,B,F AND G BUT ONLY WITH RESPECT TO THE PREMISES DESIGNATED ABOVE. ---------------------------------------------------------------------------- c_'P, i Miv rnuran 1 1 HIVU t AOUAL I T lNaUKAN1,t UUMPAN i 1 l / V // UU PERSONAL EXCESS LIABILITY POLICY INSURANCE DECLARATIONS ST 46 POLICY NUMBER: 534-64-66 -PAGE* .POLICY TERM: FROM 12-12-2000 TO TRANSACTION TYPE: RENEWAL 12-12-2001, 12:01 A.M. STANDARD EFFECTIVE: 12-12-2000 TIME AT THE ADDRESS OF THE INSURED AS STATED HEREIN. BILL TO: INSURED - NS FOR SERVICE C800-422-4272 OR WRITE TO: METLIFE AUTO & HOME P.O. BOX 48020 SCOTT K AND ERIN J NEWCOM DAYTON, OH 45475 19117 OLYMPIC VIEW DRIVE FOR CLAIMS, SEE CLAIMS DIRECTORY EDMONDS. WA 98020 UNDERLYING POLICY INFORMATION REQUIRED UNDERLYING INSURANCE LIMITS IF UNDERLYING INSURER IS METROPOLITAN UTOMOBILE: $100,000/$300,000 BODILY INJURY AND $50,000 PROPERTY DAMAGE OR $300,000 SINGLE LIMIT ($325,000 IN TEXAS) OMEOWNERS OR COMPREHENSIVE PERSONAL: $1;.00,000. LIMIT PER OCCURRENCE FOR PERSONAL INJURY AND PROPERTY DAMAGE ATERCRAFT:.$;100,000/$300,000 BODILY INJURY AND $50,000 PROPERTY DAMAGE OR $100,000 SINGLE LIMIT LL OTHER LIABILITY (RECREATIONAL VEHICLES, ETC.): $100,000 LIMIT PER OCCURRENCE FOR BODILY INJURY AND PROPERTY DAMAGE REQUIRED UNDERLYING. INSURANCE LIMITS IF UNDERLYING INSURER IS NOT METROPOLITAN UTOMOBILE: $250,000/$500,000 BODILY INJURY AND $100,000 PROPERTY DAMAGE OR $300,000 SINGLE LIMIT.($325,000 IN TEXAS) OMEOWNERS OR COMPREHENSIVE PERSONAL: .;.3p LIMIT PER OCCURRENCE FOR PERSONAL INJURY AN�PROPER`T'Y "D MAGE ATERCRAFT: $300,000 LIMIT PER OCCURRENCE FOR BODILY INJURY AND PROPERTY DAMAGE LL OTHER LIABILITY (RECREATIONAL VEHICLES, ETC.): $300,000 LIMIT PER OCCURRENCE FOR BODILY INJURY AND PROPERTY DAMAGE NDERLYING POLICY TYPE AND # UNDERLYING INSURER UNDERLYING LIABILITY LIMITS JTOMOBILE 534646634 METROPOLITAN $ 100,000/ 300,000/ 50,000 )MEOWNERS 534646634 METROPOLITAN $ 100,000 )MEOWNERS 534646634 MET $ 100,000 PHIS POLICY DOES NOT PROVIDE -UNINSURED OR UNDERINSURED MOTORISTS COVERAGE NOR IS IT AVAILABLE IN YOUR STATE. i PER YOUR POLICY CONTRACT, INSURANCE AGREEMENT AND DECLARATIONS AND :NERAL CONDITIONS - SECTIONS I AND II, PARAGRAPH 2. CONCEALMENT OR ZAUD, THIS POLICY IS ISSUED BASED ON YOUR TRUE AND ACCURATE :PRESENTATIONS OF ALL THE INFORMATION CONTAINED IN YOUR APPLICATION, ICLUDING BUT NOT LIMITED TO THE FOLLOWING: l LOSS(ES) IN THE PAST 5 YEARS. 'L 1668-000 Printed in U.SA. 0591 ENDORSEMENT M 150B PERSONAL EXCESS LIABILITY POLICY AMENDATORY ENDORSEMENT A. Under SECTION III - CONDITIONS: 1. item 6. Cancellation, the first sentence of the second paragraph is deleted and replaced by: We.;may.>cancel,this:.policy.by:;notifyingyouudn--writing..at least 45.days before the date cancellation iakes effect; unless ,the: cancellation is for> reason of nonpaymentof.premium in .which case it wiH tie at, least ,10 ;days before the date cancellation takes effect. This notice will include the reason for the cancellation. 2. item 10. Our Recovery Right is deleted and replaced by: 10. Our Recovery Right. In the event of any payment under this policy, the person to whom or on whose behalf payment. is made will: a. exercise any right of recovery that person may have against any third party. b. sign and deliver to us any legal papers relating to the recovery. c. help us exercise our rights of recovery and do nothing after loss to prejudice our rights. Any amount recovered from any third party will first be applied to compensate the person to whom or on whose behalf payment is made for all damages sustained.. We will thereafter be subrogated to that person's right of recovery, to the extent of our payment. Deferment of our right of subrogation shall not result in any duplicate payment or double recovery. 3. the following item is added: Nonrenewal. We may elect not to renew this policy. We may do so by delivering to you, or mailing to you at your mailing address shown in the Declarations, written notice at least 45 days before the renewal date of this policy. This notice will include the reason for the nonrenewal. Proof of mailing will be sufficient proof of notice. B. Under SECTION IV - DEFINITIONS, the definition of "Personal Injury" is deleted and replaced by: "Personal Injury" means bodily injury, sickness, disease or disability except any communicable sickness or disease which is transmitted by sexual contact or by intravenous injection. Personal Injury includes false arrest, detention or imprisonment, malicious prosecution, libel, slander or defamation of character, invasion of privacy, wrongful eviction or wrongful entry, or mental anguish. All other provisions of the policy apply except as modified by this endorsement. .;:.. MPL 7467-000 Printed in U.SA. 0500 CITY OF EDMONDS 121 Fifth Avenue North Edmonds, Washington 98020 FAX COVER SHEET To: Scott Snyder Ogden Murphy Wallace Phone: 206 447 7000 Fax phone: 206 447 0215 CC: Date: November 29, 2001 Number of pages including cover sheet: 5 From: David K. Gebert, PE City Engineer Phone: (425) 771-0220 Fax phone: (425) 672-5750 REMARKS: ❑ Urgent ® For your review ® Reply ASAP ❑ Please comment Scott, Attached is copy of revised insurance information submitted by Mr. Newcom for his rockery encroachment permit. Regarding the 45 day cancellation notice, his policy says they can cancel by providing 45 days notice to "you". Mr. Newcom says his insurance agent says that "you" includes additional insureds. . Please refer to my fax dated November 13, 2001 for background. Is this OK? I sure hope so. I really need to get him to move his rockery. Ze ks. Gebert, David From: W. Scott Snyder [ssnyder@omwlaw.com] Sent: Friday, November 30, 2001 10:58 AM To: 'Gebert, David' Subject: RE: Newcom insurance Looks good, approved as to form. I really should see the policy to see how "you" is defined but.I don't want to beat this to death. I suggest sending the City's name and address to the insurance company in a letter stating that all notices of cancellation should be mailed to that address. If they don't have an address they will notify the city at the insured'.s home address.' -----Original Message ----- From: Gebert, David[mailto:Gebert@ci.edmonds.wa.us] Sent: Thursday, November 29, 2001 5:46 PM To: W. Scott Snyder Subject: Newcom insurance Scott, I just faxed to you the revised insurance info submitted by Mr. Newcom for his rockery encroachment permit. Please review it and let me know if it is OK. Thanks Dave 1 11/29 22:42 page 1 Mefti. e Auto & Home. MetUfe Aum i Home is a brand of Metropolitan Properly and Casualty Insuranm Company and Its Affdiaies, Wandck, M FAX TRANSMITTAL NOTICE OF CONFIDENTIALITY THIS COMMUNICATION CONTAINS CONFIDENTIAL INFORMATION AND MAY BE SUBJECT TO LEGAL PRIVILEGES: IT IS INTENDED ONLY FOR THE USE OF THE NAMED RECIPIENT BELOW. ANY USE, DISTRIBUTION, OR DUPLICATION OF THE INFORMATION CONTAINED HEREIN BY OTHER THAN THE INTENDED RECIPIENT IS STRICTLY PROHIBITED. IF YOU RECEIVED THIS COMMUNICATION IN ERROR, PLEASE NOTIFY THE SENDER IMMEDIATELY BY TELEPHONE. TO: - - INS VERIFICATION REFERENCE POLICY NUMBER FAX NUMBER: - 425-672-5750 534-64-6634-2 ------------------------------------------------------------------- ---------------------------------------------------------------------- FROM:- - - - - KATHY IQ MET PHONE: - - - 800-422-4272 EXT - 3350 FAX NUMBER: - 937-859-2674 ---------------------------------------------------------------------- SUBJECT: SCOTT R NEWCOM & ERIN J NEWCOM MESSAGE: October 17, 2001 Engineering Division Comments Newcom Encroachment Permit Application dated 10/9/01 1. Provide. sleeves for waterlines under rockery. 2 Water meters to be relocated by the City Public Works Department. Provide a letter to the City Public Works Director requesting the City to relocate the meters (lower and adjacent to rockery) and agreeing to reimburse the City for the cost of the relocation in an amount not to exceed $500 per meter ($1,000 total). (Contact Jim Waite or Scott Highland, Public Works Department, phone # 7710235 to coordinate relocation of meters and installation of sleeves) 3. Height of the rockery to be limited to one tier of rocks, or 2.5 feet, whichever is less. 4. Maximum horizontal encroachment of rockery into right of way to be limited to no more than 2 feet from the right of way edge. GRevise insurance certificate to meet minimum req�u' ements. • Limits: Personal injury liability $300,000''Property damage $100,000.✓ • The additional insured needs to be "the City of Edmorids'V'not just the "City ! (� of Edmonds Building Divisionlas indicated on the certificate submitted. 06 • These coverages must be included in the ."City named as additional insured' DI requirement. Certificate submitted does not include property damage coverage for City as additional insured, and limits personal liability to $100,000. 1� • 45 day written notice of cancellation. 6. Right of way (ROW) permit will be required to perform work in the right of way. Submit ROW permit application. Cost is $75.00. D K. GEBERT, P.E. City Engineer A _._._....:_per. --.=mod,.. .-. V�U6c 29 7,co� (9� ( -0-1 r, When recorded mail to: City Clerk City of Edmonds 121 Fifth Avenue North Edmonds, WA 98020 CONFORMED COPY 200112101018 12/10/2001 04:44 PM Snohomish P.0005 RECORDED County SPACE ABOVE THIS LINE FOR RECORDER'S USE Assessor's Parcel No. ,00 `/$ gDDG 9, Z Project No. & Name: ENCROACHMENT AGREEMENT This ENCROACHMENT AGREEMENT ("Agreement") is entered into between the CITY OF EDMONDS ("City") and _��; rx ��,,,, IT ("Owner[s]"), in accordance with Chapter 18.70 of the Edmonds Community Development Code. 1. The Property. Owner is the owner of that certain real property located at within the City of Edmonds, Washington, Assessor's Parcel Numbero0V50�S 14 and more particularly described in Exhibit "A" attached hereto and incorporated herein by reference. Business owner, is the business owner of that certain real property noted above. 2. The Easement. The City currently owns an existing easement over, under, and across Owner's property for street, alley, sidewalk, other ( if//,4 ) which is described in Exhibit `B" attached hereto and incorporated by reference. 3. The Encroachment. The City hereby covenants and agrees and grants its permission to Owner or Business Owner to allow to remain in a portion of the City right-of-way/easement. A plat map showing the location of the encroachment is attached as Exhibit "C" and incorporated by reference. This Agreement is subject to, the following terms and conditions: . a. The encroachment shall be installed and maintained in a safe and sanitary condition at the sole cost, risk, and responsibility of the owner and its successors in interest. b. The Owner shall agree at all times to indemnify and hold the City free and harmless fromany and all claims, demands, losses, damages or expenses resulting from the - 1 - construction, maintenance, use, repair or removal of the structure installed hereunder, including any loss, damage or expense arising out of (1) loss or damages to property and (2) injury to or death of persons. C. . The Owner must remove or relocate any part of the encroachment within ten (10) days or such other time as specified in the notice after receipt of it from the City Engineer, or the City Engineer may cause such work to be done and the reasonable cost thereof shall constitute a lien upon the property. d. Whatever rights and obligations were acquired by the City with respect to the easement shall remain and continue in full force and effect and shall in no way be affected by city's grant of permission to construct and maintain the encroachment structure. 4. Entire Agreement. This Agreement constitutes the entire agreement between the parties with respect to the subject matter hereof and supersedes and replaces all other agreements, oral or written, between the parties with respect to the subject matter. . 5.. Notices. Any notice which is required or may be given pursuant to this Agreement shall be sent in.writing•by United States mail, first class, postage pre -paid, registered or certified with return receipt requested,, or by other comparable commercial means and addressed as follows: If to the Citv: City Engineer City of Edmonds 121 Fifth Avenue North Edmonds, WA 98020 If to the Owner: which addresses may be changed from time to time by providing notice to the other party in the manner described above. 6. Waiver. City's consent to or approval of any act or omission by Owner shall not constitute a waiver of any other default by Owner and shall not be deemed a waiver or render unnecessary City's consent for approval to any subsequent act by Owner. Any waiver by City of any default must be in writing and shall not be a waiver of any other default concerning the same or any other provision of the Agreement. -2- 7. Successors and Assigns. This Agreement shall be binding and inure to the benefit of the parties hereto and their respective legal representatives, successors, and assigns. Owner agrees to incorporate this agreement by reference in any subsequent deeds to the property, but any failure to do so does not invalidate this provision. 8. Capacity. Each party represents that the person(s) executing this Agreement on behalf of such party has the authority to execute this Agreement and by such signature(s) thereby bind such party. y IN WITNESS WHEREOF, the parties hereto have executed this Agreement on this day of , 20 G / OWNER By: By: STATE OF WASHINGTON ) COUNTY OF SNOHOMISH ) This day, personally appeared before me, �Scztf gl- L-0; i to me known to Ae the person(s) who executed the within d foregoing document and that (he/she/they) signed the same as (his/her/their) free and voluntary act and deed for the uses and purposes therein mentioned,,,? ---- CARLA Rav ML►T'"+ NOTARY B- S'TATE � W� PMLt 1�3. 2003 _— CITY OF EDMONDS GINEERING DIVISION i ypcu ur rnnLea IN ame My Commission expires: / 3 --G 3 0:ISHAMTEMP\BUMDINGUiAND0U7lEnttoaehAgm.doc — 3 — EXHIBIT A Legal Description: Edmonds Sea View Tracts BLK 000 D-01 — W 150sgft of S '/z Lot 81 Less N 6ft of W 150ft of Lot 81 & W 1.... 75 Range/Town/Section: R-03E T-27N S 13 — Q SE Parcel No. 4346 000 08101 QUARTER SECTION TOWNSHIP N.W.B,L, RANGE E.W.M. S E 13 27 3 J 4-UI/ {{4- 1b vl718 T YhYiH+H+ -___-...L--_''YHi Y4i 5{h+•H4'h 4'h H+1 03 76t 02 OZ *i'i Nk 06 03 3 AR 8 KEAD 1 +N+H+H+7f4 5 3 00 h 1 i.: 'j 02 # 02 0214 2 SFt S-1744 = Of LIU I 2 '� 3 ' - - - - — - - — 03 = +H+H+HSSH+H+H+IS. 63 791 * 4-025 � 78 20 �++H+.y+H+i+l9 04 04 = 21 a4-024 H+H+H44F . t5 4-030 4-026 � 22 01 02 Z. * 04 =-P YM%wAk64H+H+4H �� * 03ai h.Y N-0 Hf N4 t 118 = = 4-028 4-029 � �90 r �r 02 - B of 01 N 0 ED){ I IN a } -2 03 05 ti +H+HH{F4}H++ 03�, �� { 2 r I f 01 81 A 02 tG 0202 +►+ nY61 V{w,+Yh4FH+ ' Q 401" #.. } 04 a ; *� 04 01 4-074 4-125 i= �O 4H+H+HYAY ;��' �+h 4- � Yhwjyjm h4}{+ri4 C 82x a 01 N 05 06 03 1 01 = 03 t 04 O1 H+ri+Hwh 63 r p2 x ITTENDEN'S 04 r. +H+H+H+HYhhY,SSFH+H+H+Hf 1 r Z DTE.x 03 � j 6 +W AYAH+H+H+ffhlt +H+ O}H}H+H I+H+H.HfHiiYhY 2 q 6 02 84 t O1 08 07HOW 14 2. x HSYhSFFI+H+Hr%+ASWhYhYrSYAYrS TI (4251) 4 3 4 01 66 # 02 60 06 Y +HH+H+H+i+H+H 3 Of Q� l 2 ENCROACHMENT PERIVIIT ROUTING FORM . PERMIT #: 00 1 DATE APPLICATION RECEIVED: o ADDRESS OF PUBLIC 11SE: jq t I C)o (D. . PROPERTY OWNER: ' ONCE YOUR REVIEW IS COMPLETE, PLEASE ROUTE TO THE NEXT DIVISIONIDEPARTMENT ON THE LIST. * * * PLEASE ROUTE IN THE ORDER SHOWN * * * PLANNING DIVISION Date Stamp Received: 7 F 0 C T Ir PUBLIC WORKS Date Stami),Received: ENGINEERING DIVISION Date Stamp Received: n(,r RE �E TVED A107- �WR-OIA59, S66- a0"A4*--PjT!s OCT 17 2001 : : IN DIVISION iW` DS ADMINISTRATION Date Stamp Received. WDI 7 0, APPROVAL SIGNATURES AND REMARKS OR COMMENTS ARE TO BE MADE UNDER THE "DEPARTMENT APPROVALS" SECTION ON THE PERMIT. -RAengr\fbrms\Encroachment permit routing OF EDP O Si— . 1 g9" ENCROACHMENT PERMIT APPLICATION PROPERTY OWNER NAME:Phone PROPERTY OWNER MAILING ADDRESS: !c1// Dc-seiaPic tow bAaj,i_<AA- 990Z0 , BUSINESS NAME for Commerical applications: N/ ADDRESS OF PUBLIC USE: /19// --,4 e!)I-- X "/ 'be( (/_ , ��i.i o..i�+s G7A . %80Zx) *************************************************************************************** Describe the portion of public space, City right-of-way or easement area to be utilized (i.e., overhead space of sidewalk, 100 foot City utility easement along north property line, etc): Describe the t e of encroachment or use desired (i.e., fence 6 feet by 150 feet, awning 3 feet wide by 7 feet ,, , - long, etc.): cuter l' z z /.�� by =l0 �c,2 0,4g e, ",- �.V-== Specify the length of time for use (i.e. awning for life of building, espresso cart for summer months, etc.), —L"J —Net—I Mr` 1L NOTE: The issuance of this permit is understood by the applicant to be of a temporary nature and that no vested right is granted. INDEMNITY: The applicant understands and by his/her signature to this application, agrees to hold the City of Edmonds harmless from any injuries, damages or claims of any kind or description whatsoever, foreseen or unforeseen, that may be made against the applicant or the City of Edmonds, or any of its departments or employees, including but not limited to the defense or any legal proceedings including defense costs, court costs, and attorney fees by reason of granting this permit. In addition, the application understands that the City shall be provided a Certificate of Insurance to indemnity and hold harmless the City of Edmonds from all claims and/or property damage, and naming the City of Edmonds as an additional insured. CODE APPLICATION: By signing the application below the applicant warrants that s/he has read or had the opportunity to read Chapter 18.70 of the Edmonds Community Development Code and s/he understands that all terms of the adopted ordinance are incorporated herein as if set forthl0 fu1kgnd,0is application and permits therefore are subject to the terms of that Chapter. al INESS OWNER TE /,*14h Encroachho.docj lg 10/00 CRITERIA OF PERMIT APPROVAL The applicant shall follow the noted conditions on the building permit. For applications that do not require a building permit the following criteria shall be maintained at all times. ➢ Provide safe pedestrian travel for sidewalk encroachments. Maintain a clear zone of 44 inches minimum. See definition of clear zone below. ➢ Exterior light fixtures, banners and flags must be a minimum of 7 feet above City right-of-way. ➢ Maintain clear landings on the exterior side of all required exit doors of 44 inches or no less than width of door, measured toward the street. ➢ No projections into City alleys are permitted unless the projection exceeds 15 feet above pavement surface. ➢ Do not block illumination from City light fixtures or hang objects from City light standards. ➢ Architectural projections from buildings must be approved by the Design Board and conform to Uniform Building Code requirements. A building permit shall be required for such projections. ➢ Maintain 3 feet of clearance around fire hydrants, standpipes, manholes, water meters, blowoffs, cleanouts and valves, ➢ Bistro dining tables and chairs must be placed in accordance with City Ordinance No. 3293. ➢ Merchandise racks, espresso carts, flower planters, benches must not be located within the "clear zone". ➢ Ramps require a separate building permit and must conform to UBC standards. Clear Zone Definition: Clear Zone refers to. an area 7 feet in height and 44 inches in width providing a level, safe walking surface along the public sidewalk (i.e. measuring 44 inches from edge of street tree grates or newspaper stands toward place of business and from the juound up to a height of 7 feet). ------------------DEPARTMENT APPROVALS ---FOR CITY USE ONLY ------------------- Planning Division Approved By . /, i/w�U(AADB# -7-- Date /1,_// 1 010 L Remarks or Comments: f�f2b,i -,( y44-y&-V. ?,` iN Pr'l6vAT-. T}ovu- ST-t,.c�TLC xt,, ! S Su. . Public Works Approved By LAI Date //- 29 — o l Remarks or Comments: Engineering Division Approved Remarks or Comments: 56Z CDiu "a Certificate of Insurance Verified By Easement Agreement sent to City C ENCROACHMENT PERMIT#_WzV—,M1,q ISSUANCE DATE RELEASED BY BUILDING PERMIT # 1 RECORDING # Encroachho. do cj lg 10/00 November 30, 2001 Engineering Division Comments Newcom Encroachment Permit Application dated 10/9/01, Rev 11/29/01 Approved with the following comments: 1. Rockery construction to be in accordance with revised drawing dated November 29, 2001. 2. Height of the rockery to be limited to one tier of rocks, or 2.5 feet, whichever is less. 3. Maximum horizontal encroachment of rockery into right of way to be limited to no more than 2 feet from the right of way edge. DAVID K. GEBERT, P.E. City Engineer 11/29 .22:42 page 2 METROPOLITAN PROPERTY AND CASUALTY INSURANCE COMPANY ULTRA HOMEOWNERS ..EVIDENCE OF INSURANCE ---------------------------------------------------------------------------- POLICY NUMBER: 534-64-6634-2 TRANSACTION TYPE: POLICY CHANGE POLICY TERM: FROM 04/28/01 TO 04/28/02 TRANSACTION EFFECTIVE: 11/29/01 PROCESS DATE:,, 11/29/01 ---------------------------------------------------------------------------- SCOTT K NEWCOM AND ERIN J NEWCOM HUSBAND AND WIFE, AS JOINT TENANTS 19117 OLYMPIC VIEW DRIVE EDMONDS WA 98020 ---------------------------------------------------------------------------- THE PURPOSE OF THIS EVIDENCE OF INSURANCE IS TO PROVIDE DWELLING INSURANCE PROTECTION FOR YOUR HOME.AT TIME OF CLOSING WITH THE MORTGAGEE LISTED BELOW. ---------------------------------------------------------------------------- BASIC POLICY COVERAGES LIMITS COVERAGE A - DWELLING $3021100 COVERAGE B - PRIVATE STRUCTURES 60,420 ---------------------------------------------------------------------------- REPLACEMENT PLUS COVERAGE APPLIES TO COVERAGE A X YES _ NO ---------------------------------------------------------------------------- COVERAGE C - PERSONAL PROPERTY $226,575 COVERAGE F - PERSONAL LIABILITY 300,000 COVERAGE G - MEDICAL PAYMENTS TO OTHERS EACH PERSON 1,000 TOTAL PREMIUM: $ 991 ---------------------------------------------------------------------------- THE RESIDENCE PREMISES IS LOCATED AT: 19117 OLYMPIC VIEW DRIVE EDMONDS WA 98020 ---------------------------------------------------------------------------- DEDUCTIBLES: $250 ---------------------------------------------------------------------------- 1ST MORTGAGEE INFORMATION: 2ND MORTGAGEE INFORMATION: WASHINGTON FEDERAL SAVINGS ITS SUCCESSORS AND/OR ASSIGNS 425 PIKE STREET SEATTLE WA 98101 LOAN NO. 050-200-2316396 ------------------ ---------------------------------------------------------- COVERAGES F AND G APPLY TO THE ADDITIONAL INSURED PREMISES, LOCATED AT: 121 5TH AVE NORTH EDMONDS WA 98020 ---------------------------------------------------------------------------- ADDITIONAL INSURED: CITY OF EDMONDS THE DEFINITION OF THE INSURED IS AMENDED TO INCLUDE THE PERSON OR ORGANIZATION SHOWN ABOVE WITH RESPECT TO COVERAGES A,B,F AND G BUT ONLY WITH RESPECT TO THE PREMISES DESIGNATED ABOVE. ---------------------------------------------------------------------------- �tymw METROPOLITAN PROPERTY AND CASUALTY INSURANCE COMPANY 11/07/00 °"°"'&d°' PERSONAL EXCESS LIABILITY POLICY INSURANCE DECLARATIONS ST 46 .POETC7 NUMBER:— — — GE POLICY TERM: FROM 12-12-2000 TO TRANSACTION TYPE: RENEWAL 12-12-2001, 12:01 A.M. STANDARD EFFECTIVE: 12-12-2000 TIME AT THE ADDRESS OF THE INSURED AS STATED HEREIN. BILL TO: INSURED — —NAMINSURED: 0 SERVICE CA800-422-4272 OR WRITE TO: METLIFE AUTO & HOME P.O. BOX 48020 SCOTT K AND ERIN J NEWCOM DAYTON, OH 45475 19117 OLYMPIC VIEW DRIVE FOR CLAIMS,SEE CLAIMS DIRECTORY EDMONDS. WA 98020 UNDERLYING POLICY INFORMATION REQUIRED UNDERLYING INSURANCE LIMITS IF UNDERLYING INSURER IS METROPOLITAN UTOMOBILE: $100,000/$300,000 BODILY INJURY AND $50,000 PROPERTY DAMAGE OR $300,000 SINGLE LIMIT ($325,000 IN TEXAS) OMEOWNERS OR COMPREHENSIVE PERSONAL: $100,000 LIMIT PER OCCURRENCE FOR. PERSONAL INJURY AND PROPERTY DAMAGE ATERCRAFT: $100,000/$300,000 BODILY INJURY AND $50,000 PROPERTY DAMAGE OR $100,000 SINGLE LIMIT LL OTHER LIABILITY (RECREATIONAL VEHICLES, ETC.): $100,000 LIMIT PER OCCURRENCE FOR BODILY INJURY AND PROPERTY DAMAGE REQUIRED UNDERLYING INSURANCE LIMITS IF UNDERLYING INSURER IS NOT METROPOLITAN UTOMOBILE: $250,000/$500,000 BODILY INJURY AND $100,000 PROPERTY DAMAGE OR $300,000 SINGLE LIMIT ($325,000 IN TEXAS) OMEOWNERS OR COMPREHENSIVE PERSONAL:­$30�LIMIT PER OCCURRENCE FOR PERSONAL `INJURY AND_ -PROPERTY DAMAGE, ATERCRAFT: $300,000 LIMIT PER OCCURRENCE FOR BODILY INJURY AND PROPERTY DAMAGE LL OTHER LIABILITY (RECREATIONAL VEHICLES, ETC.): $300,000 LIMIT PER OCCURRENCE FOR BODILY INJURY AND PROPERTY DAMAGE NDERLYING POLICY TYPE AND # UNDERLYING INSURER UNDERLYING LIABILITY LIMITS UTOMOBILE 534646634 METROPOLITAN $ 100,000/ 300,000/ 50,000 3MEOWNERS 534646634 METROPOLITAN $ 100,000 3MEOWNERS 534646634 MET $ 100,000 THIS POLICY DOES NOT PROVIDE UNINSURED OR UNDERINSURED MOTORISTS COVERAGE NOR IS IT AVAILABLE IN YOUR STATE. S PER YOUR POLICY CONTRACT, INSURANCE AGREEMENT AND DECLARATIONS AND =NERAL CONDITIONS — SECTIONS I AND II, PARAGRAPH 2. CONCEALMENT OR BAUD, THIS POLICY IS ISSUED BASED ON YOUR TRUE AND ACCURATE PRESENTATIONS OF ALL THE INFORMATION CONTAINED IN YOUR APPLICATION, VCLUDING BUT NOT LIMITED TO THE FOLLOWING: ) LOSS(ES) IN THE PAST 5 YEARS. r IPL 1668-000 Printed in U.SA. 0591 ENDORSEMENT M 150B PERSONAL EXCESS LIABILITY POLICY AMENDATORY ENDORSEMENT A. Under SECTION III - CONDITIONS: 1. item 6. Cancellation, the first sentence of the second paragraph is deleted and replaced by: We may cancel this policy by notifying you in writing at least 45 days before the date cancellation takes effect, unless the cancellation is for reason of nonpayment of premium, in which case it will be at least 10 days before the date cancellation takes effect. This notice will include the reason for the cancellation. 2. item 10. Our Recovery Right is deleted and replaced by: 10. Our Recovery Right. In the event of any payment under this policy, the person to whom or on whose behalf payment is made will: a. exercise any right of recovery that person may have against any third parry. b. sign and deliver to us any legal papers relating to the recovery. c. help us exercise our rights of recovery and do nothing after loss to prejudice our rights. Any amount recovered from any third parry will first be applied to compensate the person to whom or on whose behalf payment is made for all damages sustained. We will thereafter be subrogated to that person's right of recovery, to the extent of our payment. Deferment of our right of subrogation shall not result in any duplicate payment or double recovery. 3. the following item is added: Nonrenewal. We may elect not to renew this policy. We may do so by delivering to you, or mailing to you at your mailing address shown in the Declarations, written notice at least 45 days before the renewal date of this policy. This notice will include the reason for the nonrenewal. Proof of mailing will be sufficient proof of notice. B. Under SECTION IV - DEFINITIONS, the definition of "Personal Injury" is deleted and replaced by: "Personal Injury° means bodily injury, sickness, disease or disability except any communicable sickness or disease which is transmitted by sexual contact or by intravenous injection. Personal Injury includes false arrest, detention or imprisonment, malicious prosecution, libel, slander or defamation of character, invasion of privacy, wrongful eviction or wrongful entry, or mental anguish. All other provisions of the policy apply except as modified by this endorsement. MPL 7467-M Printed in USA. 0500 CITY OF EDMONDS 121 Fifth Avenue North Edmonds, Washington 98020 FAX COVER SHEET To: Scott Snyder Ogden Murphy Wallace Phone: 206 447 7000 Fax phone: 206 447 0215 CC: Date: November 29, 2001 Number of pages including cover sheet: 5 From: David K. Gebert, PE City Engineer Phone: (425) 771-0220 Fax phone: (425) 672-5750 REMARKS: ❑ Urgent ® For your review ® Reply ASAP ❑ Please comment Scott, Attached is copy of revised insurance information submitted by Mr. Newcom for his rockery encroachment permit. Regarding the 45 day cancellation notice, his policy says they can cancel by providing 45 days notice to "you". Mr. Newcom says his insurance agent says that "you" includes additional insureds.. Please refer to my fax dated November 13, 2001 for background. Is this OK? I sure hope so. I really need to get him to move his rockery. Zv ks. Gebert, David From: W. Scott Snyder [ssnyder@omwlaw.com] Sent: Friday, November 30, 2001 10:58 AM To: 'Gebert, David' Subject: RE: Newcom insurance Looks good, approved as to form. I really should see the policy to see how "you" is defined but I don't want to beat this to death. I suggest sending the City's name and address to the insurance company in a letter stating that all notices of cancellation should be mailed to that address. If they don't have an address they will notify the city at the insured's home address. -----Original Message ----- From: Gebert, David[mailto:Gebert@ci.edmonds.wa.us] Sent: Thursday, November 29, 2001 5:46 PM To: W. Scott Snyder Subject: Newcom insurance Scott, I just faxed to you the revised insurance info submitted by Mr. Newcom for his rockery encroachment permit. Please review it and let me know if it is OK. Thanks Dave 1 11/29 22:42 page 1 meftHe Auto& Home Metlife Auto i Home is a brand of Metropolitan Property and Casualty Insurance Company and Its Affiliates, Worwict, RI FAX TRANSMITTAL NOTICE OF CONFIDENTIALITY THIS COMMUNICATION CONTAINS CONFIDENTIAL INFORMATION AND MAY BE SUBJECT TO LEGAL PRIVILEGES: IT IS INTENDED ONLY FOR THE USE OF THE NAMED RECIPIENT BELOW. ANY USE, DISTRIBUTION, OR DUPLICATION OF THE INFORMATION CONTAINED HEREIN BY OTHER THAN THE INTENDED RECIPIENT IS STRICTLY PROHIBITED. IF YOU RECEIVED THIS COMMUNICATION IN ERROR, PLEASE NOTIFY THE SENDER IMMEDIATELY BY TELEPHONE. TO: - - - - INS VERIFICATION REFERENCE POLICY NUMBER FAX NUMBER: - 425-672-5750 534-64-6634-2 ---------------------------------------------------------------------- ---------------------------------------------------------------------- FROM:- - - - - KATHY IQ MET PHONE: - - - - 800-422-4272 EXT - 3350 FAX NUMBER: - 937-859-2674 ---------------------------------------------------------------------- SUBJECT: SCOTT K NEWCOM & ERIN J NEWCOM MESSAGE: 0 October 17, 2001 Engineering Division Comments Newcom Encroachment Permit Application dated 10/9/01 1. Provide sleeves for waterlines under rockery. 2 Water meters to be relocated by the City Public Works Department. Provide a letter to the City Public Works Director requesting the City to relocate the meters (lower and adjacent to rockery) and agreeing to reimburse the City for the cost of the relocation in an amount not to exceed $500 per meter ($1,000 total). (Contact Jim Waite or Scott Highland, Public Works Department, phone # 7710235 to coordinate relocation of meters and installation of sleeves) 3. Height of the rockery to be limited to one tier of rocks, or 2.5 feet, whichever is less. 4. Maximum horizontal encroachment of rockery into right of way to be limited to no more than 2 feet from the right of way edge. Revise insurance certificate to meet minimum req�u�ements. • Limits: Personal injury liability $300,000, roperty damage $100,000.✓ • The additional insured needs to be "the City of Edmonds'rno-t just the "City 1 v of Edmonds Building Division'=as indicated on the certificate submitted. ,- (tv These coverages must be included in the "City named as additional insured' requirement. Certificate submitted does not include property damage coverage for City as additional insured, and limits personal liability to $100,000. 45 day written notice of cancellation. 6. Right of way (ROW) permit will be required to perform work in the right of way. Submit ROW permit application. Cost is $75.00. /DK. GEBERT, P.E. City Engineer i . . m r�Q When recorded mail to: City Clerk City of Edmonds 121 Fifth Avenue North Edmonds, WA 98020 I,'�Y�IINIp'0la�lfl21I1V�Q12/10/2001 04:44 PM Snohomish �YM'�'W' P-0005 RECORDED County RECORDER'S NOTE: PORT�OROF THIS DOCUMENT ARE PO Q AL Ty FOR SCANNING. SPACE ABOVE THIS LINE FOR RECORDER'S USE Assessor's Parcel No. Project No. & Name: ENCROACHMENT AGREEMENT This ENCROACHMENT AGREEMENT ("Agreement") is entered into between the CITY OF EDMONDS ("City") and cT ("Owner[s]"), in accordance with Chapter 18.70 of the Edmonds Community Development Code. 1. The Property. Owner is the owner of that certain real property located at /9// K�.el vc , within the City of Edmonds, Washington, Assessor's Parcel NumberOd�.3�,/(,DeDd /G/ and more particularly described in Exhibit "A" attached hereto and incorporated herein by reference. Business owner, is the business owner of that certain real property noted above. 2. The Easement. The City currently owns an existing easement over, under, and across Owner's property for street, alley, sidewalk, other ( &141 ) which is described in Exhibit `B" attached hereto and incorporated by reference. 3. The Encroachment. The City hereby covenants and agrees and grants its permission to Owner or Business Owner to allow. to remain in a portion of the City right-of-way/easement. A plat map showing the location of the encroachment is attached as Exhibit "C" and incorporated by reference. This Agreement is subject to the following terms and conditions: a. The encroachment shall be installed and maintained in a safe and sanitary condition at the sole cost, risk, and responsibility of the owner and its successors in interest. b. The Owner shall agree at all times to indemnify and hold the City free and harmless from any and all claims, demands, losses, damages or expenses resulting from the -1- construction, maintenance, use, repair or removal of the structure installed hereunder, including any loss, damage or expense arising out of (1) loss or damages to property and (2) injury to or death of persons. C. The Owner must remove or relocate any part of the encroachment within ten (10) days or such other time as specified in the notice after receipt of it from the City Engineer, or the City Engineer may cause such work to be done and the reasonable cost thereof shall constitute a lien upon the property. d. Whatever rights and obligations were acquired by the City with respect to the easement shall remain and continue in full force and effect and shall in no way be affected by city's grant of permission to construct and maintain the encroachment structure. 4. Entire Agreement. This Agreement constitutes the entire agreement between the parties with respect to the subject matter hereof and supersedes and replaces all other agreements, oral or written, between the parties with respect to the subject matter. 5. Notices. Any notice which is required or may be given pursuant to this Agreement shall be sent in writing -by United States mail, first class, postage pre -paid, registered or certified with return receipt requested, or by other comparable commercial means and addressed as follows: If to the City: City Engineer City of Edmonds 121 Fifth Avenue North Edmonds, WA 98020 If to the Owner: which addresses may be changed from time to time by providing notice to the other party in the manner described above. 6. Waiver. City's consent to or approval of any act or omission by Owner shall not constitute a waiver of any other default by Owner and shall not be deemed a waiver or render unnecessary City's consent for approval to any subsequent act by Owner. Any waiver by City of any default must be in writing and shall not be a waiver of any other default concerning the same or any other provision of the Agreement. 26O112101018 7. Successors and Assigns. This Agreement shall be binding and inure to the benefit of the parties hereto and their respective legal representatives, successors, and assigns. Owner agrees to incorporate this agreement by reference in any subsequent deeds to the property, but any failure to do so does not invalidate this provision. 8. Capacity. Each party represents that the person(s) executing this Agreement on behalf of such party has the authority to execute this Agreement and by such signature(s) thereby bind such party. IN WITNESS WHEREOF, the parties hereto have executed this Agreement on this day of , 20 G / . OWNER By: By: STATE OF WASHINGTON ) COUNTY OF SNOHOMISH ) This day, personally appeared before me, 5 Otf � to me known to Ae the person(s) who executed the within d foregoing document and that (he/she/they) signed the same as (his/her/their) free and voluntary act and deed for the uses and purposes therein mentioned,.,,? /- CAR A RAY M%-R— Novay PUBM STATE 0F COMMISSION APRIt 13, !W _ CITY OF EDM, ONDS By: GINEERING DIVISION G:\SHARE\TEMP\BUILDING\HANDOLJMncroachAgree.doc i ypeu or rrmieu iv ame My Commission expires: K / 3-6 3 EXHIBIT A Legal Description: Edmonds Sea View Tracts BLK 000 D-01 — W 150sgft of S % Lot 81 Less N 6ft of W 150ft of Lot 81 & W 1... 75 Range/Town/Section: R-03E T 27N S 13 — Q SE Parcel No. 4346 000 08101 718 ' g-vii AR 1BTKEAE b a 3 79�, 4-025 {. i 21 1 5 4-030 - 4-026 »g =4-028 RRY--STk---- QP 4-074 �xHr�/r d o 200112101-11 ------p i 04 iH+H+WAY' 03a, r ' a 11/26/2001 15:33 4254818401 , CAJUN EXCAVATING PAGE 02 ­ X— 0% r %A 4z0. 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Y )DEYELOFM h-Z CO)DE"(Photlts 429-771-MO, Rxl: 1326) . FDW Z AFPg0YAL 17F AwZ RM2=D WVXK, 'DATE:__ /napseeGr'a Sisu4ltra 15 6- PCV14Zq MtIS-r � - vollwA 2101tw C5 f2 7-11( Me'. APPROVED BY ENGINEERING Date: Cr- 11/27/2001 13:31 4254818401 CAJUN EXCAVATING PAGE 04 COMMERCIAL WILLIAM BAUGH FARMERS INSURANCE AGENCY 14400 Bel -Red Rd 5TE 110 BELLEVUE, WA 98007 425 641-0367 5t. 79 Dist. 37 4gent 30 INSURED: Cajun Excavating, Inc 20611 Uothell-Everett Hw Bothell, Wa 98012 5t of Wa #CAJ'UNEC10362 CERTIFICATE OF INSURANCE ISSUE DATE 04/19/01 This certificate 1s issued as a matter of information only and confers no rights upon the certificate holden. This certificate does not amend, extend or alter the coverge afforded by the policies shown below. COMPANIES PROVIDING COVERAGE: Comp Letter A TRUCK INSURANCE EXCHANGE: 4249 Comp Letter 8 FARMERS INSURANCE EXCHANGE Comp Letter C MID-CENTURY INSURANCE COMPANY Comp Letter D COVERAGES This 15 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 wnicn thl.s 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 Co [,t] Type of Ins IPolicv # I Bf-f Dt1 Exp. Dtl Policy Llaits B IGeneral Llab 1600940003105/10/0110S/10/021General Aggregat(01.,000,000 x ICommercia.l I I I (Prod-Comp/Ops I IGeneral Llab I I I (Aggregate I$2,000,00o z I -Occurrence 1 I I (Personal and Ad-1 I Version I I 1 Ivertlsing InjuryIS1,000,000 I I I I (Each Occurrence 1$1,000,000 (Contractual- ( I I (Fire Damage I (Incidental 1 I I ((Any One. Eire) 1$ S0,000 I 1 1 1 (Medical. Expense I Istop Gap I 1 l I(Any One Person)IS 5.000 A (Automotive 1600940003105/10/01105/10/021Comb. Single Lmt1$1,000,000 ILiability I I I I I x (Ali Owned I I I. IAodi.l.y Injury I commercial ( I I I(Fer Person) IS 15cheduled ( I I IBodi.ly Injury I IFlired I I ( I (Per Accident) (S x [Non -Owned I I ( (Property Damage I$ tiara a Liab. I lGarage A q q re q ate , (Umbrella Liabl l 1 1,&imit 1 DESCRIpT'ION OF OPERATIONS/VEliICf,]ES/RESTRIC.TIONS ,:IpFCIAL ITEMS CERTIFICATE HOLDER CANCELLATION Should any of the above de- scribed pol.i.ci.es be cancelled before the Department of Labor It Industries expiration date thereof, the issuing compa- Contractors Registration Section ny will endeavor to mail 30 days written P. 0. Box 44450 notice To the certif.icaty holder named to Olympia, Wa 98504-44s0 the left, but failure to mail such notice shall impose no obli.gaT.ion or liability of rr,,JJ any kind upon the company, its agents or Wi.(tZ�✓1 (6. Gy'-` representatives. Authorized Representati e APR 2 3 2001 LICENSE DETAIL INFORMATION Form Pagel 1 'of 2 STATE OF WASHINGTON DEPARTMENT OF LABOR AND INDUSTRIES Specialty Compliance Services Division P. O. Box 44000 Olympia, WA 98504-4000 THE RESULT OF YOUR INQUIRY FOR LICENSE NUMBER SELECTED IS: LICENSE DETAIL INFORMATION Current Filter: None Registration# or License CAJUNE1103C2 Name CAJUN EXCAVATING INC Address 20611 BOTHELL EVERETT HWY 249 Address City BOTHELL State WA Zip 98012 Phone Number 4254815659 Effective Date 2/22/90 Expiration Date 5/9/02 Registration Status ACTIVE Type CONSTRUCTION CONTRACTOR Entity CORPORATION Specialty Code EXCAVATION/GRADING Other Specialties OTHER (SPECIFY) UBI Number 601222035 * * *VIEW CROSS REFERENCE FILE FOR THIS LICENSE* * * *VIEW PRINCIPAL OWNER(S) FOR THIS LICENSE... * * *VIEW CONTRACTOR BOND/SAVINGS INFORMATION * * * * * *CHECK INQUIRY FOR SUMMONS AND COMPLAINTS* * * * * * VIEW CONTRACTOR INSURANCE INFORMATION * * * New inquiry by CITY, NAME, PRINCIPAL OWNER NAME, NUMBER, UBI NUMBER or return to the L&I Construction Compliance Home Page https://wws2.wa.govAni/bbip/TF2Form.asp?License=CAJUNEI103C2 11/29/2001 MetLife Auto& Home Metropolitan Property and Casualty Insurance Company V.I.P. Ultra Homeowners Insurance Declarations 11/26/01 [%T A 11 Policy Number: 5346466342 Page 1 of 2 Policy Term: From 04-28-2001 to 04-28-2002, 12:01 A.M. Standard Time Duplicate Effective Date: 11-26-2001 at the location of the property insured as stated in the policy. Bill To: Mortgagee First Additional Insured: Named Insured: SCOTT K NEWCOM AND ERIN J NEWCOM CITY OF EDMONDS HUSBAND AND WIFE, AS JOINT TENANTS 121 5TH AVE NORTH 19117 OLYMPIC VIEW DRIVE EDMONDS WA 98020 EDMONDS WA 98020 Residence Premises: Named Insured's Address Shown Above. Basic Policy Coverages Limits Premiums A - Dwelling $ 302,100 $ 670.00 B - Private Structures $ 60,420 C - Personal Property $ 226,575 F - Personal Liability $ 300,000 $ 14.00 G - Medical Payments to Others: Each Person $ 1,000 Loss of Use $ 75,525 Additional Coverages Replacement Plus Incl Replacement Cost on Contents Incl Optional Coverages 1 - Earthquake and Volcanic Eruption: 15% Deductible $ 307:00 - Current Annual Premium: $ 991.00 Deductible(s) $250 deductible applies to each loss. Forms and Endorsements: 7083-046 (0698) H868 H770 H774 H793 H371 H373 H329 H611 Discounts for the following have been included in the current annual premium: * 15% Protective Device Discount * 100k Multi -Policy Discount Rating Information Territory 14 Within 05 miles of 1 Family Protection Class 4 Fire Department: Built in 1980 Within 1000 ft of hydrant EDMONDS Frame Construction MetLife® Auto & Home is a brand of Metropolitan Property and Casualty Insurance Company and its Affiliates, Warwick, RI MPL 1380-000 Printed in U.S.A. 0298 Meftife Aut0 & Home Metropolitan Property and Casualty Insurance Company V.I.P. Ultra Homeowners Insurance Declarations 11/26/01 Policy Number: 5346466342 Page 2 of 2 Policy Term: From 04-28-2001 to 04-28-2002, 12:01 A.M. Standard Time Duplicate Effective Date: 11-26-2001 at the location of the property insured as stated in the policy. Bill To: Mortgagee Messages As per your Policy Contract, Insurance Agreement and Declarations and General Conditions - Sections I and II, Paragraph 2. Concealment or Fraud, this policy is issued based on your true and accurate representations of all the information contained in your application, including but not limited to the following: No loss(es) in the past 5 years. The cost of any coverage indicated as "Incl" is included in the Basic Policy Coverages premium amount. This Policy Does Not Provide Coverage for Flood Damage. Additional Insured/Mortgagee First Additional Insured: CITY OF EDMONDS The definition of the insured is amended to include the person or organization shown above, with respect to coverages A, B, F and G, at the insured premises only. First Mortgagee: WASHINGTON FEDERAL SAVINGS ITS SUCCESSORS AND/OR ASSIGNS ASS_IGN_S 425 PIKE STREET _ - - SEATTLE WA 98101 For service, call 800-422-4272 or write to: MetLife Auto & Home P.O. Box 48020 Dayton, OH 45475 For claims, see Claim Directory. Your Metropolitan Sales Office: FOCUS FIN GRP WA Tel: (425) 806-9588 95J-560-1 MdUfe® Auto & Home is a brand of Metropolitan Property and Casualty Insurance Company and its Affiliates, Warwick, RI PO BOX 48020, DAYTON, OHIO 45475-0020 ADDRESS SERVICES REQUESTED 95J 560 1 H4666342DD53464000DBlIll CITY OF EDMONDS 121 5TH AVE NORTH EDMONDS WA 98020 ME [4 o v Sr. UJ. W O it Lw �. Z Z Imo® 0� w rL W w LL IL Cc w o' ° c;-;, a 0 C ❑ � n. 0 5 < O Q m • FENCE To im oN PRtVwCe- opOIL • CJW►,�2 R�S�Ns i6t.E �•OR- ��'[��M tNIN6't STRSTREETFlP,.A..Ty1py 0 W oz zF= rnw az d w� 8U am a S N 0 V 2 9 2001 BUILDING DEPT. RECEIVED NOV 2 9 2001 Miller, Noel From: Gebert, David Sent: Friday, November 30, 2001 11:32 AM To: Miller, Noel Cc: Kammerer, Jim; Waite, Jim; Harrison, Marie; McConnell, Jeanie Subject: Newcom rockery Noel, Mr. Newcom has now got his insurance squared away for his encroachment permit. I have signed off on it. Could you please stop by to see Marie Harrison today to sign off on it (or ask Jim K. or Jim W.) to do so. Thanks. Dave ' CA File No: � '0(' 135 Critical Areas Checklist Site Information (soils/topography/hydrology/vegetation) 1. Site Address/Location: I 1 :� 04*onpie— l , ��..� -bp.i J! 2. Property Tax Account Number: 3. Approximate Site Size (acres or square feet): _ 4. Is this site currently developed? yes; no. If yes; how is site developed? HeI ,o s� 5. Describe the general site topography. Check all that apply. Flat: less than 5-feet elevation change over entire site. Rolling: slopes on site generally less than 15% (a vertical rise of 10-feet over a horizontal distance of 66-feet). Hilly: slopes present on site of more than 15% and less than 30% ( a vertical rise of 10-feet over a horizontal distance of 33 to 66-feet). Steep: grades of greater than 30% present on site (a vertical rise of 10-feet over a horizontal distance.of less than 33-feet),. , _ Other (please describe): G EiJ'r'Lv-- 6. Site contains areas of year-round standing water: % ; Approx. Depth: 7. Site contains areas of seasonal standing. water: Approx. Depth: What season(s) of the year?),,l 8. Site is in the floodway floodplain of a water course. 9. Site conf Gins a creek or an area where water flow_ s across the grounds surface? - Flows are year-round? V Flows are seasonal? (What time of year? ). 10. Site is primarily: forested: ; meadow (1<' ; shrubs ; mixed urban landscaped (lawnshrubs etc) �c 11. Obvious wetland is present on site: /Ua Critical Areas Checklist.doc/3.19.2001 City of Edmoads-,A. _ ; LCfit ceived: (� �/ O Development Services Department eipt #: Planning Division ` , ' ° : _ ' = .Areas File:# ` ;. .Phone: 425.771.0220 Areas Checklist Fee:$45.00 Fax: 425.7710221 ailed to'Aoolicant: The Critical Areas Checklist contained on this form -is to be filled out by any person preparing a Development Permit Application for the City of Edmonds prior to his/her submittal of the application to the City. The purpose of the Checklist is to enable City staff -to• determine whether any potential Critical. Areas _are,, .or may be, present on the subject property. The information needed to complete the Checklist should be easily available from observations of the site or data available at City Hall (Critical areas inventories, maps, or soil. surveys). A property owner,' or His/her authorized representative, must fill out, the checklist,:sign, and date it, and' submit it to the City. The City will review the checklist, make a precursory site visit, and `make 'a determination of the subsequent steps , necessary to complete a development permit application. Please submit a vicinity map,, along with the signed copy of this form to assist City staff in finding and locating the specific piece of propertydescribed on this form.. • In addition, the: applicant. shall -include other pertinent information (e.g. site plan,.. topography map, etc.) or studies'in conjunction with-tliis Checklist to assistant staff in completing their preliminary assessment of the site. The undersigned applicant, and his/her/its heirs, and assigns; -in consideration on the processing of the application agrees to release, indemnify, defend and hold the City of Edmonds_�harmless from,any-and all 'damages,' includingireasonable attorney's fees, arising from any action or infraction based. in whole or part upon . false, misleading, inaccurate or incomplete information furnished by the applicant, his/her/its agents or employees: By my signature, I certify that the information and exhibits herewith submitted are true, and correct to the best of my knowledge and that I am authorized to file this application on the behalf of the owner as listed below. SIGNATURE OF APPLICANT/AGENT DATE Property Owner's Authorization By my signature, I certify that I have authorized the above Applicant/Agent to apply for the subjectland use application, and grant my permission for the public o i and the staff of the -City -of Edmonds to enter the subject property for the purposes of inspection a��►is application. /. Owner/Applicant: Name lei //� �Lv/'►�1PIC 1/�Fc:)1.�,ert/F ; Street Address 02ID City tate Zip Telephone: Email address (optional):. Applicant Represeptative: --Name Street Address City State Zip Telephone: Email Address (optional): Critical Areas Checklist.doc/3.19.2001 1:0 -.ft. " 0 rn a STRE'E.-T F41E�� �-a " H H C-n ix CD 0 CD C+ Ft, ct (D CD W tr CD (1) tj CD c+ c+ --Is 0 0 11 (D 0 H ft. . H m CA w d O. 0 0 I-b P-1 1-1 0 Flb tc) ;N y DD CD :0 IL CD 0 CD 0 C+ C+ CA 0 Fj to 0 r 0, m " -K CD C+ V-4 H* CD CD :CD rn ca -4 0 0 C+ C+ 0 to C+ 0 `-lb 0 to 10 0 Ft 11 C+ to 0 CD 0 C+ C+ tz C+ 03 (30 0. CD Fj tv Rio A --a 0 ID 0 30 -4 t2i CD C+ 0 z 0 CD 0 0 Gl 0 C+ 0 tr (D I-D 0 (D :0 tY CD CD 0 ;8 C+ C+ r:r (D CD Fj 0 c+ CD 0 rn 0 C+ OD C) F-J 0 F-i 04 0 M o F- (FQ c+ r:r tiA c+ CD C+ 0 0 CD C+ V►EW -Dr`%ve CEnter o� -2-1 CArIvewc-y O i yrn Pic view Drove ti i 0 00 z z z c oo a �`� CD m Z C7 y oa aq 9 i N am an , t" OH o°gfr y c 1 :0 ` y � ,b GO, 177 m 0 0 4 5.4 QQ 7 o z g Z p p',� ORE m ' f a� i w t1nn° O pro mp� o tpy ,00 m V •°I h ryM N E C m E3a m ce 0 o i0 m an 2 e m m E m ^ ^I o W a c� CA 'qg M N E DATE RECEIVED g p� l `•., 'PERMIT EXPIRES USE PERMIT "CITY OF EDMONDS ZONE NUMBER�� �r r CONSTRUCTION PERMIT APPLICATION JOB V SUIT FJ TN 1: ADDRESS / OWNER NAME/NAME OF. BUSINESS . G Y0,111 PLAT NAME/SUBDIVISION NO. LOT O. LID NO. GCa� T E�r+J F tJ C LID FEE $ W MAILING ADDRESS TES Cp Approved 0 PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP RW permit Required 0 O ( ��% P. C W r V Street Use Permk Req•d CII,Y ZIP TELEPHONE EXISTING PROPOSED Inspection Required Sidewalk Required / 0 r ('" Q �j� �� 1 `��� rj - 5 f' REQUIRED DEDICATION FT Underground V,` G / 1 C_ ,? Widng requhad NAME METER SIZET INE SIZE NO. OF FIXTURES PRV REQUIRED t7 / .. YES ❑ NO ❑ z W REMARKS Z 11DDRESS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE Lei CITY ZIP TELEPHONE / AJ J` J Q ENGINEERING REVIEWEDTTE. ADDRESS -`'elk a � •vim' FIRE AEVIEWED BY DATE W U CITY ZIP TELEPHONE M VARIANCE OR CU SHORELINE OR ADBN ...�„« INSPECTION RE 'D BOND POSTED STATE LICENSE NUMBER EXPIRATION DppTE CHECKED BY . `Jt/i❑YES /�� NO SERA REVIEW SIGN AREA HEIGHT 0 PROPERTY TAX ACCOUNT PARCEL NO. 7 0007" O - COMPLETE EXEMPT I ALLO fED PROP/O/,SED t4 ALLOW PROPOSED 61 I .� EXP (� ❑ NEW RESIDENTIAL ❑ PLUMBING / MECH LOT COVERAGE ALLO ED PROP/.SED: ',.REQUIREb SETBACKS FT)•. • ..., SIDE a RREAR' 11 PRQPO ED SETBACKS (FL) f.��r1pN�` C/R SIDE�pIy�REAR ❑ AUDITION ❑ COMMERCIAL ❑ COMPLIANCE OR ��� ' it) �, �I ^"�IS-M ' •A , O 2 CHANGE OF USE PARKINGPOVIDED ' APARTMENT ❑ ❑ ❑ SIGN RED'D LOT AR)~A;:. P NG.REV EWW_'. DATEREMODEL o. GRADING FENC I ' ❑ REPAIR ❑ CYDS ( X FT) REMAR PER, �n ����A �TS6 DEMOLISH � TANK � OTHER •4• '' 11 u up Z o ❑ GARAGE CARPORT ❑ RETAINING WALL_ , ❑ ROCKERYRENEWAL / " 1 1"`�fa d Y Ic+ IF -Le Stir, t0 { 1/ �l- :�{v (TYPE OF USE. BUS% ESS OR ACTIVITY) EXPLAIN: . F CHECKED BY TYPE OF CONSTRUCTION Com �j�'-'. // `7 OCCUPANT GROUP 43 CL E c¢i '`,� OF 2 NUMBER OF. DWELLING CRITI AREAS CNUMBER Gam+ � SPECIAL INSPECTOR AREA OCCUPANT O STORIES lT UNITS NUMBE REQUIRED ❑ YES LOAD DESCRIBE WORK TO BE DONE REMARKS C7 46nIGE /���9 ; �i�nfs illPP,FDy.. PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REO'D o m ne, �O0 r,. / A^ �A-)- 7; e c /A)/ �'' �/�1� tv //;�R � �r VALUATION FEE PLAN CHECK FEE HEAT SOURCE GLAZING LOT SLO BUILDING PLAN CHEC NO: ••••�/// VESTED DATE PLUMBING MECHANICAL THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBUC GRADING/FILL J DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE 2—�.. SEPARATE PERMISSION. 2 ..STAvKSURCHARGE W PERMIT APPLICATION: 180 DAYS a PERMIT LIMIT: 1 YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS ENG. REVIEW FEES SEE BACK OF PINK PERMIT FOR MORE INFORMATION y to 'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS ENG. INSPECTION FEE lu IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF LANDSCAPING a EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND INSPECTION FEE a ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY RECEIPT = FROM THE ISSUANCE'OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE PLAN CHECK DEPOSIT i DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE i NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION., PIECEI 7 — as TOTAL AMOUNT DUE I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION GIVEN IS CORRECT; AND THAT 1 AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF APPLICATION APPROVAL THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- CALL This application is not a permit until signed by the TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED Building Official or his/her Deputy: and Fees are paid, and IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION Areceipt is acknowledged in space provided. WORKMEN'S CO E I INSURANCE AND RCW 18.27. OFFI A S SIGNATURE DATE SI NT) U W EDATE SIG7�_-,7 (425) �� 0 771-0220 1 A I' EXT 333 REyE'ASED BY DA E <? �" ! ,;1 i� f �; e,r IT IS UNLAWF4L TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL !`i' /7 1 �:-'I MADE AND 771-0221 A FINAL INSPECTION HAS BEEN APPROVAL OR A CERTIFI- CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 FAy ORIGINAL •FILE YELLOW - INSPECTOR PINK -OWNER GOLD •ASSESSOR 7E 5/98"� �swex ;�r - .-.y:. .,. . ' 3 . � - �. F� � s `, ':._.,.ice x.-. .... '4: �', � .. .. .yq•... �, � -�,' ,. City of Edmonds PermitNo: q i RIGHT-OF-WAY CONSTRUCTION PERMIT Issue Date: r �/ A. Address or Vicinity, of Construction:�c! I / OW r+n PIG (/, E tO bk i ✓� B. Type of Work (bee specF4�% N�6� nt�ov a L 64 .5or s bi R IQN� Puac � MF00- �F �'k1lar��r %2©LKg 7a C. Contractor: d&-rUA% 6>0AAT/d 6 J Contact:MR.. NeWOM Mailing Address:"// "Phone: State License #: x. %W�r'/ Liability Insurance: Bond: $ D. Building Permit'# (if applicable): Side Sewer Permit # (if applicable): E. ❑ Commercial ❑ Subdivision ❑ City Project, ❑ EUC (PUD,VERIZON, PSE, AT& T, OVWD) ❑ Multi -Family Single ,Family ❑ Other INSPECTOR: WON I F. PAVEMENT CUT: ❑ YES NO G. I SIZE OF CUT X CONCRETE CUT: ElYES 19NO INDEMNITY. • Applicant understands by his/her signature to this application he/she: holds the City of Edmonds harmless from injuries, damages or claims of any kind or description whatsoever, foreseen or unforeseen, that may be made against the City of Edmonds or ahy of its departments or employees, including but not limited to the defense of any legal proceedings including defense costs and attorney fees by reason ofgranting this permit. THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR A PERIOD OF, ONE YEAR FOLLOWING THE FINAL INSPECTION AND ACCEPTANCE OF THE WORK. ESTIMATED RESTORATION FEES WILL BE HELD UNTIL THE FINAL STREET PATCH IS COMPLETED BY CITY FORCES, AT WHICH TIME A DEBIT OR. CREDIT WILL BE PROCESSED FOR ISSUANCE TO THE APPLICANT. ♦ Traffic control and public safety shall be in accordance with City, regulations as required by the City Engineer. Every flagger must be trained as required by (WAC) 296-155-305 and . must have certification verifying completion of the required training in their possession. ♦ Restoration is to be in accordance with City codes. All street -cut trench work shall be patched with asphalt or City - approved material prior to the end of the workday — NO EXCEPTIONS. ♦ Three sets of construction drawings of proposed work are required with the permit application.' CALL DIAL -A -DIG (1-800-424-5555) PRIOR TO BEGINNING WORK I HAVE READ THE ABOVE STATEMENTS AND UNDERSTAND THE PERMIT REQUIREMENTS AND ACKNOWLEDGE THAT I MUST MAKE THE PINK COPY OF THE PERMIT AVAILABLE ON SITE AT ALL TIMES FOR -INSPECTIONS Signature: See (,rjla('hed T01x Date: (Contractor or Agent) FOR CITY USE ONLY r Approved b Right-of-way Fee: :76 ' J Time Authorize : Void After 0/ / 31 / 0 4 Disruption Fee/Fund 111: Special Conditions:, Restoration Fee: 44 17 4-W hJZ:F-A _ IN :'1ZOA1T 6T IZZK-FP� 1ND Total Fee: 1U21A1 N J1`) 11 Tl U T%V--.5 • JZ-0-W TO B!F— LA 0Dr�K Receipt No: 1NfTl-i Fi>zASS QI� LAW C-►tjclN1wn Sfii�gILSS t. mLe, SS Issued by: -Ly C04 y:: �,-rl9 NI�t��S : ��}G� MEl S't � �� t�11i1�1t� � ►: Tt�G� t���zT��Ll:��.-: UPON COMPLETION OF PERMITTED WORK, AN. ENGINEERING FINAL INSPECTION IS REQUIRED PER CHAPTER 18.00 OF THE EDMONDS' COMMUNITY DEVELOPMENT CODE (Phone 425; 77 �0220, Ext. 1326 FINAL APPROVAL OFPERMIT_ TED WORK: DATE: �2 0 Inspector s Signature, For inspection requirements see Engineering Inspection Information handout. DAMy Documents\Forms\Engnmg\ROWpermit_ doc +w