HomeMy WebLinkAboutPW16-208 - Original - City of Kent - Moore Property Disclosure Statement - 05/10/2016 o � _
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CONTRACT COVIER SHEET
' Crime hs to, be completed by the Contract Manager priorr tosujbmjsslon
to Comity Clerks Office. All portions are Ito be completed.
f you have questions, please Q.; ntaw¢:t City (Clark'(Clark's office.
Vendor Name: CiN of AvAt
Vendor Humber,.
JD Edwards Wimber
Contract err:
This is assigned by City Clerk's Office
Project Name., MOOS` — Pi
10
Description: 0 Inter oval .
Interl greetnent ❑ Change Order F] Arnendment El Conti-actp o aid
C o tract, Effective Date. � � Termination Date.- � ._
Contract ct"tt Reneuv ai Notice (Days)
Number of days required notice for termination or renewal or amendment
Contract Man aacg vo M i j j — Depa rtmen t;
Contract;t ount.m
Approval Authority: ❑ Department Director ,Mayor ❑City COUncii
Detail: i.e. address, location, paincel number, tax ird', etc.).-
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EXHIBIT B
SELLER'S DISCLOSURE STATEMENT
INSTRUCTIONS TO THE SELLER
Please complete the following form. Do not leave any spaces, blank. If the question clearly
does not apply to the property write "NA." If the answer is "yes" to any * items, please
explain on attached sheets. Please refer to the line number(s) of the question(s) when you
provide your explanation(s). For your protection you must date and sign each page of this
disclosure statement and each attachment. Delivery of the disclosure statement must occur
not later than five business days, unless otherwise agreed, after mutual acceptance of a
written contract to purchase between a buyer and a seller.
NOTICE TO THE BUYER
THE FOLLOWING DISCLOSURES ARE MADE BY SELLER ABOUT THE CONDITION OF THE
PROPERTY LOCATED AT A-fje- tjj,! WASHINGTON, ("THE
PROPERTY"), OR AS LEGALLY DESCRIBED ON ATTACHED EXHIBIT
SELLER MAKES THE FOLLOWING DISCLOSURES OF EXISTING MATERIAL FACTS OR
MATERIAL DEFECTS TO BUYER BASED ON SELLER'S ACTUAL KNOWLEDGE OF THE
PROPERTY AT THE TIME SELLER COMPLETES THIS DISCLOSURE STATEMENT., UNLESS YOU
AND SELLER OTHERWISE AGREE IN WRITING, YOU HAVE THREE BUSINESS DAYS FROM
THE DAY SELLER OR SELLER'S AGENT DELIVERS THIS DISCLOSURE STATEMENT TO YOU
TO RESCIND THE AGREEMENT BY DELIVERING A SEPARATELY SIGNED WRITTEN
STATEMENT OF RESCISSION TO SELLER OR SELLER'S AGENT. IF THE SELLER DOES NOT
GIVE YOU A COMPLETED DISCLOSURE STATEMENT, THEN YOU MAY WAIVE THE RIGHT TO
RESCIND PRIOR TO OR AFTER THE TIME YOU ENTER INTO A SALE AGREEMENT,
THE FOLLOWING ARE DISCLOSURES MADE BY SELLER AND ARE NOT THE
REPRESENTATIONS OF ANY REAL ESTATE LICENSEE OR OTHER PARTY. THIS
INFORMATION IS FOR DISCLOSURE ONLY AND IS NOT INTENDED TO BE A PART OF ANY
WRITTEN AGREEMENT BETWEEN BUYER AND SELLER.
FOR A MORE COMPREHENSIVE EXAMINATION OF THE SPECIFIC CONDITION OF THIS
PROPERTY YOU ARE ADVISED TO OBTAIN AND PAY FOR THE SERVICES OF QUALIFIED,
EXPERTS TO INSPECT THE PROPERTY, WHICH MAY INCLUDE, WITHOUT LIMITATION,
ARCHITECTS, ENGINEERS, LAND SURVEYORS, PLUMBERS, ELECTRICIANS, ROOFERS,
BUILDING INSPECTORS, ON-SITE WASTEWATER TREATMENT INSPECTORS, OR
STRUCTURAL PEST INSPECTORS. THE PROSPECTIVE BUYER AND SELLER MAY WISH TO
OBTAIN PROFESSIONAL ADVICE OR INSPECTIONS OF THE PROPERTY OR TO PROVIDE
APPROPRIATE PROVISIONS IN A CONTRACT BETWEEN THEM WITH RESPECT TO ANY
ADVICE, INSPECTION, DEFECTS OR WARRANTIES,
Seller ...... ...... is/ X is not occupying the property.
DATE:-,"z/ /,0 11% SELLER: —SELLER:
Seller's Disclosure Statement - Page I of 12
Improved Ver. Effective 07-24-15
I. SELLER'S DISCLOSURES:
*If you answer "Yes" to a question with an asterisk (*), please explain your answer and
attach documents, if available aind not otherwise publicly recorded. If necessary, use an
attached sheet.
1. TITLE
.Yes I No [ ] Don't know A. Do you have legal authority to sell the
property? If no, please explain.
Yes No [ ] Don't know *B. Is title to the property subject to any of
the following?
(1) First right of refusal
(2) Option
(3) Lease or rental agreement
(4) Life estate?
Yes KNo [ ] Don't know -4:c. Are there any encroachments, boundary
agreements, or boundary disputes?
KYes No [ ] Don't know *D. Is there a private road or easement
1
agreement for access to the property?
Yes No [ I Don't know *E. Are there any rights-of-way, easements,
or access limitations that may affect the Buyer's
use of the property?
Yes [ ] Nio [ ] Don't know *F. Are there: any written agreements for joint
maintenance of an easement or right-of-way?
Kyes [ ] No [ ] Don't know *G. Is there any study, survey project, or
notice that would adversely affect the property?
Yes KNo [ ] Don't know H. Are there any pending or existing
assessments against the property?
Yes 'X'No [ ] Don't know *I. Are there any zoning violations,
nonconforming uses, or any unusual restrictions
on the property that would affect future
construction or remodeling?
I 'Yes [ ] No [ ] Don't know *J. Is there a boundary survey for the
property?
01
Ikyes [ ] No [ ] Don't know K. Are there any covenants, conditions, or
restrictions recorded against the property?
SELLER:DATE:- SELLER:
Seller's Disclosure Statement - Page 2 of 12
Improved Ver. Effective 07-24-15
2. WATER
A. Household Water
(1) The source of water for the property is:
�Private or publicly owned water system
( Private well serving only the subject
Property
Other water system
'Yes No Don't know If shared, are there any written agreements?
Yes X No Don't know *(2) Is there an easement (recorded or
unrecorded) for access to and/or maintenance of
the water source?
Yes [ No Don't know (3) Are there any problems or repairs
needed?
NXYes [ No [ ] Don't know (4) During your ownership, has the source
provided an adequate year-round supply of
potable water? If no, please explain.
Yes "' f'No [ ] Don't know *(5) Are there any water treatment systems
for the property? If yes, are they Leased
Owned.
Yes � No [ ] Don't know *(6) Are there any water rights for the
property associated with its domestic water
supply, such as a water right permit, certificate,
or claim?
I Yes [ ] No on't know (a) If yes, has the water right, permit,
certificate, or claim been assigned,
,transferred, or changed?
[ ] Yes [ ] No 'Don't know (b) If yes, has all or any portion of the
water right not been used for five or more
Successive years? (If yes, please explain)
*(7) Are there any defects in the operation of
the water system (e.,g, pipes, tank, pump, etc.)?
(If yes, please explain)
B. Irrigation Water
Yes Don't know (1) Are there any irrigation water rights for
the property, such as a water permit, certificate,
or claim?
DATE: BELLE - SELLER:
Seller's Disclosure Statement - Page '31 of 12
Improved Ver, Effedive 07-24-15
Yes [ ] No KDon't know (a) If yes, has all or any portion of the
water right not been used for five or more
successive years?
Yes [ ] No [Don't know (b) If so, is the certificate available? (If
"A—C
yes, please attach a copy.)
Yes No O-Ja2n't know *(c) If so, has the water right permit,
certificate, or claim been assigned,
transferred, or changed? If so, explain:
Yes
,)(,No Don't know (2) Does the property receive irrigation water
from a ditch company, irrigation district, or other
entity? If so, please identify the entity that
supplies irrigation water to the property:
C. Outdoor Sprinkler System
Yes [ ] No Don't know (1) Is there an outdoor sprinkler system for
the property?
Yes [ ] No t4Don't know (2) If yes, are there any defects in the
system?
Yes No Don't know *(3) If yes, is the sprinkler system connected
to irrigation water?
3. SEWER/ON-SITE SEWAGE SYSTEM
A. The property is served by:
Public sewer system
On-site sewage system (including
3ipes, tanks, drainfields, and all other
component parts)
[ ] Other disposal system, please
describe-
Yes No Don't know B. If public sewer system service is available
to the property, is the house connected to the
sewer main? If no, please explain.
Yes *43 Don't know *C. Is the property subject to any sewage
system fees or charges in addition to those
covered in your regularly billed sewer or on-site
sewage system maintenance service?
DATE:- _SELLER:, � SELLER:
Seller's Disclosure Statement - Page 4 of 12
Improved Ver. Effective 07-24-15
D. If the property is connected to an on-
site sewage system:
Yes [] No Kpon't know *(I) Was a permit issued for its
construction, and was it approved by the
local health department or district
following its construction?
(2) When was it last pumped:
Yes No Doni't know *(3) Are there any defects in the
operation of the on-site sewage system?
Don't know (4) When was it last inspected? �P) I zi oi
By whom: -r-i-cr� ,
Don't know (5) For how many bedrooms was the
on-site sewage system approved?
Bedrooms
KYes No [ ] Don't know E. Are all plumbing fixtures, including
laundry drain, connected to the sewer/on-site
sewage system? If no, please explain:
Yes <No [ ] Don't know F. Have there been any changes or repairs to
the on-site sewage system?
KYes No [ ] Don't know G. Is the on-site, sewage system, including
the drainfield, located entirely within the
boundaries of the property? If no, please
explain.
Yes No Don't know H, Does the on-site sewage system require
monitoring and maintenance services more
frequently than once a year? If yes, please
explain:
NOTICE: IF THIS RESIDENTIAL REAL PROPERTY DISCLOSURE STATEMENT IS BEING
COMPLETED FOR NEW CONSTRUCTION WHICH HAS NEVER BEEN OCCUPIED, THE SELLER
IS NOT REQUIRED TO COMPLETE THE QUESTIONS LISTED IN ITEM 4, STRUCTURAL OR
ITEM 5. SYSTEMS AND FIXTURES.
4. STRUCTURAL
Yes No Don't know *A. Has the roof leaked within the last five
years?
Yes [>�No Don't know *B. Has the basement flooded or leaked?
Yes No Don't know *C. Have there been any conversions,
1 additions, or remodeling?
DATE:..'� /11 11,6—SELLER:. —SELLER:
Seller's Disclosure Statement - Page 5 of 12
Improved Ver. Effective 07-24-15
[ ] Yes No Don't know (1) If yes, were all building permits
obtained?
Yes No Don't know *(2) If yes, were all final inspections
obtained?
Yes No [Don't know D. Do you know the age of the house? If
yes, year of original construction:
Yes No Don't know *E. Has there been an settling, slippage, or
sliding of the property or its improvements?
[ ], Yes [ ] NoDon't know *F. Are there any defects with the following:
1<1 (If yes, please check applicable items and
explain.)
El Foundations El Decks El Exterior Walls
[:1 Chimne s El Interior Walls El Fire: Alarm
[:1 Doors El Windows El Patio
El Ceilings _ El Slab Floors El Driveways
Pools 0 Hot Tub El saunas
El Sidewalks El Outbuildings El Fireplaces
[j Ga!:agtFloors [:1 Walkways El Siding
El Other El Wood Stoves Elevators
El Incline Elevators Ej Stairway Chair Lifts Wheelchair Lifts,
Yes No IX"Qon't know *G. Was a structural pest or "whole house"
inspection done? If yes, when and by whom was
the inspection completed?
Yes No Don't know H. During your ownership, has the property
had any wood destroying organism or pest
infestation?
Yes No n't know I Is the attic insulated?
Yes No (*,Don't know J. Is the basement insulated?
5. SYSTEMS AND FIXTURES
*A. if any of the following systems or fixtures
are included with the transfer, are there any
defects? If yes, please explain,
Yes No Don't know * Electrical system, including wiring,
switches, outlets, and service.
Yes &No Don't know * Plumbing,system, including pipes,
faucets, fixtures, and toilets.
Yes � No Don't know a Hot water tank
Yes No Don't know Garbage disposal
N.
DATE: —SELLER: —SELLER:
Seller's Disclosure Statement - Page 6 of 12
Improved Ver. Effective 07-24-15
,
[ l Yes PQNo [ l Don't know aApp[iances
T lYes [ | No X]]on'1know " Sump pump
� lYes [ l No N Don`tknow - Heating and cooling systems
[ l Yes [ l No �� Don't knoVv oSecurltysystern
' [ 1 Owned [ l Leased
[ l Other
B. If any of the following fixtures or property
is included with the transfer, are they leased? (If
` yes, please attach copy of lease.)
[ lYes KNo [ ] Don't know Security system
[ No Yes P�� F ~� [}un'� �n�vv Tanks (type):
^ ~ �`�� ^
[ lYes N c � l Don't know Satellite dish
F ��Yes [ lN� Don't know Other:
^ ~ ` ' ��*�
*C. Are any ofthe following kinds ufwood
burning appliances present otthe property?
[ Yes �� Nn � � Don't {1\ VyOodstove?
~ . ~ � '
Yes � l No [ l Don't /2� Fireplace insert?
^ ~ ` '
[ l Y8� �@ No � l Don't know (�\ Pellet stove?
^ ^ ` ~ ` .
[ 7 Yes �� No [ l Don't know (4) Fireplace?
^ ~ ` '
[ l Yes [ l No [���}on^� �n�vv If yes, are all of the ��) vvmo�stoves or [��
- ~ ^ ^ ^�� ` , ` '
fireplace inserts certified by the U.S.
Environmental Protection Agency asclean
. burning appliances toimprove air quality and
public health?
DATE.. SELLER: SELLER:
Seller's Disclosure Statement - Page of12
Yes [ ] No [ ] Don't know D. Is the property located within a city,
county, or district or within a department of
natural resources fire protection zone that
provides fire protection services?
Ayes [ ] No [ ] Don't know E. Is the property equipped with carbon
monoxide alarms?
(Note: Pursuant to RCW 19.27.530, seller must
equip the residence with carbon monoxide alarms
as required by the state building code.)
Kyes No Don't know F. Is the property equipped with smoke
alarms?
6. HOMEOWN ERS' ASSOCIATION/COMMON INTERESTS
Yes No on't know A. Is there a Homeowners' Association?
Name of the Association and contact information
for an officer, director, employee, or other
authorized agent, if any, who may provide the
association's financial statements, minutes,
bylaws, fining policy, and other information that
is not publicly available:
KY es No Don't know B. Are there regular periodic assessments:
$ p e r Month Year &tk-'
,N�Other KoroT- Soi-e-
Yes No Don't know *C. Are there any pending special
assessments?
Yes No Don't know *D, Are there any shared "common areas" or
any joint maintenance agreements (facilities such
as walls, fences, landscaping, pools, tennis
courts, walkways, or other areas co-owned in
undivided interest with others)?
7. ENVIRONMENTAL
Yes No Don't know *A. Have there been any flooding, standing
water or drainage problems on the property that
affect the property or access to the property?
Yes No Don't know *B. Does any part of the property contain fill
dirt, waste or other fill material?
DATE:--5/--/49 A-—SELLER:-��-� SELLER:
Seller's Disclosure Statement - Page 8 of 12
Improved Ver. Effective 07-24-15
Yes No Don't know *C. Is there any material damage to the
property from fire, wind, floods, beach
movements, earthquake, expansive soils, or
landslides?
Yes No Don't know D. Are there any shorelines, wetlands,
'y floodplains, or critical areas on the property?
Yes No Don't know *E, Are there any substances, materials, or
products on the property that may be
environmental concerns, such as asbestos,
formaldehyde, radon gas, lead-based paint, fuel
or chemical storage tanks, or contaminated soil
or water?
Yes No Don't know F. Has the property been used for
commercial or industrial purposes?
Yes No Don't know AI& Is there any soil or groundwater
contamination?
Yes No Don't know :*H. Are there transmission poles or other
utility equipment installed, maintained, or buried
on the property that do not provide utility service
to the structures on the property?
Yes No Don't know *I. Has the property been used as a legal or
illegal dumping site?
Yes No Don't know *J. Has the property been used as an illegal
drug manufacturing site:?
Yes No Don't know *K. Are there any radio towers in the area
that may cause interference with cellular
telephone reception?
a. MANUFACTURED AND MOBILE HOMES NO
If the property includes a manufactured or mobile home,
I
Yes [ ] No [ ] Don't know 014- *A, Did you make any alterations to the
home? If yes, please describe the alterations:
Yes [ ] No [ ] Don't know B. Did the previous owner make any
alterations to the home?
[ ] Yes No [ ] Don't know All,I` *C. If alterations were made, were permits or
variances for theses alterations obtained?
DATE: —S E LL E R: SELLER:
Seller's Disclosure Statement - Page 9 of 12
Improved Ver. Effective 07-24-15
9. FULL DISCLOSURE BY SELLERS
A. Other conditions or defects:
Yes No Don't know *Are there any other existing material defects
affecting the property that a prospective buyer
should know about?
B. Verification:
The foregoing answers and attached explanations
(if any) are complete and correct to the best of
my/our knowledge and I/we have received a
copy hereof. I/we authorize all of my/our real
estate licensees, if any, to deliver a copy of this
disclosure statement to other real estate
licensees and all prospective buyers of the
property.
S,
DATE: 114 SELLERP SELLER:
Seller's Dis 71osure Statement - Page: 10 of 12
Improved Ver. Effective 07-24-15
NOTICE TO THE BUYER
INFORMATION REGARDING REGISTERED SEX OFFENDERS MAY BE OBTAINED FROM LOCAL
LAW ENFORCEMENT AGENCIES. THIS NOTICE IS INTENDED ONLY TO INFORM YOU OF
WHERE TO OBTAIN THIS INFORMATION AND IS NOT AN INDICATION OF THE PRESENCE OF
REGISTERED SEX OFFENDERS.
11. BUYER'S ACKNOWLEDGMENT
A. Buyer hereby acknowledges that: Buyer has a duty to pay diligent attention to any
material defects that are known to Buyer or can be known to Buyer by utilizing diligent
attention and observation.
B. The disclosures set forth in this statement and in any amendments to this statement
are made only by the Seller and not by any real estate licensee or other party.
C. Buyer acknowledges that, pursuant to RCW 64.06.050(2), real estate licensees are
not liable for inaccurate information provided by Seller, except to the extent that real estate
licensees know of such inaccurate information.
D. This information is for disclosure only and is not intended to be a part of the written
agreement between the Buyer and Seller.
E. Buyer (which term includes all persons signing the "Buyer's acceptance" portion of
this disclosure statement below) has received a copy of this Disclosure Statement (including
attachments, if any) bearing Seller's signature.
DISCLOSURES CONTAINED IN THIS DISCLOSURE STATEMENT ARE PROVIDED BY SELLER
BASED ON SELLER'S ACTUAL KNOWLEDGE OF THE PROPERTY AT THE TIME SELLER
COMPLETES THIS DISCLOSURE STATEMENT. UNLESS BUYER AND SELLER OTHERWISE
AGREE IN WRITING, BUYER SHALL HAVE THREE BUSINESS DAYS FROM THE DAY SELLER
OR SELLER'S AGENT DELIVERS THIS DISCLOSURE STATEMENT TO RESCIND THE
AGREEMENT BY DELIVERING A SEPARATELY SIGNED WRITTEN STATEMENT OF RESCISSION
TO SELLER OR SELLER'S AGENT. YOU MAY WAIVE THE RIGHT TO RESCIND PRIOR TO OR
AFTER THE TIME YOU ENTER INTO A SALE AGREEMENT.
BUYER HEREBY ACKNOWLEDGES RECEIPT OF A COPY OF THIS DISCLOSURE STATEMENT
AND ACKNOWLEDGES THAT THE DISCLOSURES MADE HEREIN ARE THOSE OF THE SELLER
ONLY, AND NOT OF ANY REAL ESTATE LICENSEE OR OTHER PARTY.
DATE: BUYER: BUYER:
BUYER'S WAIVER OF RIGHT TO RECEIVE COMPLETED SELLER DISCLOSURE STATEMENT
Buyer has been advised of Buyer's right to receive a completed Seller Disclosure Statement.
Buyer waives that right. However, if the answer to any of the questions in the section
entitled "Environmental" would be "yes," Buyer may not waive the receipt of the
"Environmental" section of the Seller Disclosure Statement.
DATE: BUYER BUYER
n- \r,i 7r' s\nurT-h;-iqe andc -] I e=rjjSC I ncjir fn-rM
1 rcir-dp-nneLty
effective 072/415.docx inp
DATE Z 44 SELLER:4L__ —SELLER:
Seller's Disclosure Statement - Page 11 of 12
Improved Ver, Effective 07-24-15
WHEN RECORDED RETURN TO:
City of Kent
220 Fourth Avenue South
Kent, Washington 98032 C ID
ATTN: Property Services
Grantor: City of Kent, a Washington municipal corporation
Grantee:
Abbreviated Legal Description: Lot 1, Exempt Segregation No. EMSC 1S-0014,
recorded under recording number 2015O831900002, NW 1/4 of SW 1/4, Sec. 25, Twn
22N, Rng. 6E, W.M.
Additional Legal Description on:
Assessor's Tax Parcel ID No.: Portions of 252206-9107-02
STATUTORY WARRANTY DEED
The City of Kent, a Washington municipal corporation, ("Grantor"), for and in
consideration of mutual benefits derived and/or other valuable consideration receipt
of which is hereby acknowledged by Grantor, conveys and warrants to
("Grantee"), the following described real property situated in
King County, State of Washington:
SEE EXHIBIT "A" ATTACHED, hereinafter referred to as the "Property."
Reserving, however, to Grantor, its successors and assigns, a perpetual Wellhead
Monitoring Easement, for the drilling, installation, operation, maintenance,
extension, construction, alteration, reconstruction and repair of one or more
wellheads for the purpose of monitoring the existing and future groundwater, over,
under, through, across and upon the following described property attached hereto
as Exhibit "B," Under no circumstances shall Grantee cause any permanent
structures be placed or erected within this easement area, nor shall Grantee use
any portion of the easement area for vehicular parking. This Wellhead Monitoring
Easement shall be a covenant running with the land, and shall be binding on
Grantee and all future owners of the real property subject to this Easement.
Further reserving to the Grantor the right to enforce the following conditions, which
shall run with the land and be binding on all present and future owners of the
Property in perpetuity:
1. No dumping of any solid or semi-solid material on any portion of the
Property, including but not limited to: trash, litter, fertilizer or other debris.
2. No dumping or storage of any hazardous or potentially-hazardous liquids on
any portion of the Property, including but not limited to: fertilizer, pesticides,
herbicides, paint, paint thinners, automotive fluids, petroleum products, ash or any
other hazardous chemicals, other than storage of small quantities reasonably
associated with normal household use.
3. Use of fertilizers, for any reason, is prohibited on the entire Property.
4. The use of pesticides shall only be used as absolutely necessary and shall
require written permission from the Grantor and be specific as to the exact type
and application note of a pesticide.
S. No home occupation that may have a detrimental effect on groundwater
quality shall be allowed without prior written approval from Grantor. All home
occupations shall be consistent with applicable regulations of all public agencies
with jurisdiction, including, but not limited to King County.
6. The Property shall not be used for any commercial purpose other than home
office.
7. No storage of chemicals or petroleum products shall be permitted outside of
structures.
S. No new buildings, foundations, structures, fill, or obstructions (including, but
not limited to outbuildings and overhangs) are allowed within 15 feet of the
Southernmost property line.
9. No farm animals or exotic animals shall be kept or housed on the Property,
including, but not limited to: cows, horses, mules, sheep, goats, pigs, chickens,
llamas, alpacas, and fowl.
10. The keeping of domestic animals, including dogs and cats, shall be limited to
no more than two of each in quantity. No kennels or animal breeding facilities shall
be allowed on the Property.
11. The drain field and septic system shall be kept in good working order.
Annual inspection of the septic system shall be completed by a certified septic
maintenance technician and the results thereof shall be submitted to Grantor no
later than the 1't day of September each year. Unless later amended by Grantor in
writing, all results and related reports shall be mailed to City of Kent, Water
Department, Attn: Water Superintendent, 220 4tr' Avenue South, Kent, Washington
98032.
12. The Grantor reserves the right to periodically visit and inspect the Property to
ensure compliance with these conditions. Such inspection shall be permitted only
after Grantor first notifies the owner in writing, by first-class mail sent to the
Property address at least seven calendar days in advance of the planned inspection.
GRANTOR:
CITY OF KENT
By:
Title:
Date:
STATE OF WASHINGTON )
ss.
COUNTY OF KING )
I hereby certify that I know or have satisfactory evidence that Suzette Cooke is the
person who appeared before me, and said person acknowledged that she signed this instrument,
on oath stated that she is authorized to execute the instrument on behalf of the City of Kent as
its Mayor, and such execution to be the free and voluntary act of such party for the uses and
purposes mentioned in the foregoing instrument.
-Notary seal Must Appear Within This Box
IN WITNESS WHEREOF, I have hereunto set my hand and official seal the
day and year first above written.
NOTARY PUBLIC, in and for the State
of Washington, residing at
My appointment expires
APPROVED AS TO FORM:
Name:
Kent City Attorney
PACivd\Files\Open Files\MS-Moore Purchase and Sale Agreement\SWD with Restrictions as of042916.docx
Exhibit A
Lot 1, Exempt Segregation No. EMSC 15-0014, recorded under recording number
20150831900002, NW 1/4 of SW 1/4, Sec. 25, Twn 22N, Rng. 6E, W.M.
Exhibit B
The West 50' of Lot 1, Exempt Segregation No. EMSC 15-0014, recorded under
recording number 20150831900002, NW 1/4 of SW 1/4, Sec. 25, Twn 22N, Rng. 6E,
W.M.
45 REQUEST FOR MAYOR'S SIGNATURE
"F KF_NT Print on Cherry-Colored Paper
Routing Information:
(ALL REQUESTS MUST FIRST BE ROUTED THROUGH THE LAW DEPARTMENT)
Approved by Dlrector�_
Originator: Ingrid Willms-Dixon Phone (Originator): 5519
Date Sent: q/9/16 Date Required: May 13, 2016
5
N/A
Return Signed Document to: Ingrid Willms-Dixon Contract Termination ante:
VENDOR NAME: Date Finance Notified:
City of Kent (Oniy required on contracts 1 20/15
$20,000 and over or on any Grant)
DATE OF COUNCIL APPROVAL: ,1/20/15 Date Risk Manager Notified: 1/20/15
(Required,on,Non-0ty Standard Contracts/Agreements)
Has this Document been Speciflicallry Account Number:
Authorized in the Budget? 'YES U NO
Brief Explanation of Document:
The City is selling the Moore property located in Ravensdale 26726 262nd Ave S.E.
This 'is the City's disclosure statement regarding the property.
All (s*Klll&EDhrough The Law Department
ant2ftcompleted by the Law Department)
Received: T -T Approval of Law Dept.: cavA
Law De et. Comments"
Date Forwarded to MaAhMIN I I_mvv Ljc:r 1'. C"51m at
Shaded Areas To Be Completed By Administration Staff
'R�cehied,:
Alk,
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Recommendations'and'Com rut,
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