20150218171146722.pdfRETURN ADDRESS:
City of Edmonds, City Clerk
121 5th Avenue North
Edmonds, WA 98020
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201501270640 6 PGS
0112712015 2:58 �i NT00
SNOHOMISH COUNT OcSHINGTON
File "111 �'1111, nw, 11 W961 Q', NMI,
Reference#: [),u) 1,11(.1) t q - cd CN":X
Grantor(s): (I)V'6jai N\,, C'L(Wi (2) (ho�C CkjYL Additional on pg._
Grantee(s): City of Edmonds
Legal Description (abbreviated): Sec —Twn Rng_Qtr
OR Lot —Block plat
Assessor's Tax Parcel lDff(s): (1) 6' V, LY, 0 2 0, 2, (2)
Assessor's Tax Parcel ID# not yet assigned
CITY OF EDMONDS
APPROVED FOR RECORDING
BY DATE:112,71r-,> PAGE, OF (L
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:
1. Description of Su
LAPPR
..OF
..]
This covenant of notification and
indemnification/hold harmless relates to a tract of land at the street address of
street
address), Edmonds Snohomish County, Washington and legally described as:
0
IQ , 100, F."t hJ, 10 r'r
'0
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 Sf,� J,),(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
APPROVED FOR RECO "I j BY: DATE: 1112,1.
PAGE y OF
the consultants in the course of permit issuance. The conditions, limitations, or
prohibitions may require ongoing maintenance on the part of any owner or lessee or
may require modifications to the structures and earth stabilization matters in order
to address future or anticipated changes in soil or other site conditions. The
statements and conditions proposed by the OWNERS' geotechnical engineer,
geologist, architect and/or structural engineer are hereby incorporated by reference
from the contents of the file as fully as if herein set forth. Any future purchaser,
lessee, lender or any other person acquiring or seeking to acquire an interest in the
property is put on notice of the existence of the content of the file and the City urges
review of its contents. The file may be reviewed during normal business hours or
copies obtained at the Building Department, City of Edmonds, 121 Sth 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
[APPROVED FOR REC
BY: V-U3 DATE:
PA
GE k-1 OF (4
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. InsuranELBtquirem�ent. 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.
OWNER($)
]By-
- - ---------
By:
STATE OF WASHINGTON
ss:
COUNTY OF
I certify that I know or have satisfactory evidence that.
signed this instrument and
acknowledged it to be (his/her) free and voluntary act for the purposes mentioned in
this instrument.
DATED this day of
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2): NOTARY PUBLIC
My commission expires: j
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APPROVED
BY: A PRO ED FOR RECORDING:
P'
/-C�DATE:- L__
PAGE � o
E OF
STATE OF WASHINGTON
ss:
COUNTY OF
I certify that I know or have satisfactory evidence that f(ZILL�
signed this instrument and
acknowledged it to be (his/her) free and voluntary act for the purposes mentioned in
this instrument.
FIX
NOTARY PUBLIC
My commission expires:
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