Loading...
HomeMy WebLinkAboutApplication APPLICANT 3/4/2022SIRIN6FR �m[OON Fina/ P a t Name of Plat: Rosie Springs Subdivision Titles of required documents: M(Original signed plat on acid -free archivable bond paper (3 pages) O'Peclaration of Maintenance and Easement Agreement (6 pages) D'NOMA (Notice of Operations & Maintenance Agreement) (2 pages) CKCurrent Title Report Y,4ttmg Deed %Y A. copy of each of the previous for Planning CYFinal Plat Application Farm and Fee NOTE: The application is onh, complete atter you return: • 5 relied copies of the recorded plat • 3 copies of documents recorded with plat Sincerely, City Instructions: This form is to accompany the plat and the supporting documents to the Public Works Department of the City of Springfield at the time of final plat submittal. The purpose is primarily to notify the planning office that the Surveying Division has received all the documents it roquires for final plat submittal. Couuty Instructions: This form is to accompany the plat and the supporting documents to the Lane County Surveyor's Office at the time of final submittal for recording. The purpose is primarily to notify that office of which items need to he recorded simultaneously with the plat, but it also serves to remind the develop /surveyor that these documents need to he included in the final submittal package to the County Surveyor. I^" A,.mn'npvmut LLoeI i,.a.MWlndowsAJNGC hcACnt tOullook L5dQY6R7%Roae Spc6ubmitt],. City of Springfield Development & Public Works 225 Fifth Street Springfield, OR 97477 Land Division Plat Partition, Subdivision SPNINOFIE D Application Type (Applicant: check one) Partition Plat Pre -Submittal: 77Subdivision Plat Pre -Submittal: ❑ Partition Plat Submittal: Subdivision Plat Submittal: LX Required Project Information (Applicant., complete this section) Applicant Name: Ira Lucia Phone: Company: Ninth St. Properties, LLC Fax: n/a Address: 17605 NW Autumn Ridge Drive, Beaverton, OR 97006 Email: ninthstprop@outlook.com Applicant's Rep.: Jason Goshert Phone: 541-485-8383 Company: py SSW Engineers Inc. I Fax: 541-485-8384 Address: 2350 Oakmont Way, Suite 105 Email: Property Owner: * Multiple Owners - See Following Page * Phone: Company: Fax: Address: ASSESSOR'S MAP NO: 17-02-31-24 TAX LOT NOS : 11900 Property Address: 431 35th Street, Springfield, OR 97477 Size of Property: 0.93 Acres / 40,526 Square Feet Acres ❑X Square FeetX❑ Proposed Name of Subdivision: ROSIE SPRINGS Description of 11 you are filling in this form by hand, please attach your proposal description to this application. Proposal: 6 Lot residential subdivision Existing Use: Residential 811-21-000078-TYP2 Tentative Case #: 811-21-000079-TYP2 # of Lots/Parcels: 6 Avg. Lot Parcel Size: 6,754.33 sf Densit : 6.45 du/acre Si natures: Please si n and print your name and date in the a Required Project Information (City Intake Staff. Associated Applications: ro riate box on the next pae. complete this section) Pre -Sub Case No.: Date: Reviewed by: Case No.: 7-7--000D60--"R\ Date: 6ll-.1-1 z Reviewed b . Application Fee: $ Ll Technical Fee, $ Z2-3 AS Posta a Fee: 0 TOTAL FEES: $ LI QZ- �5 PROJECT NUMBER: Revised 10.14.13 kl 1 of 6 Property Owners: Property Owner 1 of 2 Laura Romine Phone: 54 /— ) Address: 120 Creekside Drive #55, Painted Post, NY 14870 Property Owner 2 of 2 Phone: Ronald Auxier Address: 3817 SW 336th Street, Federal Way, WA 98023 Owner Signatures This application form is used for both the required pre -submittal meeting and subsequent complete application submittal. Owner signatures are required at both stages in the application process. An application without the Owner's original signature will not be accepted. Owner: The u igned acknowledges that the information in this appl�is correct and accurate for duling of the Pre- Submittal Meeting. If t plicant is not the owner, the owner h grants permission for the scant to act in his/her behalf. I/we do hereby acknowle at I/we arejlegafl responsible for all statutory timelines, information, requests a ements conveyed to my representative. Print Submittal I represent this application to be complete for submittal to the City. Consistent with the completeness check performed on this application at the Pre -Submittal Meeting, I affirm the information identified by the City as necessary for processing the application is provided herein or the information will not be provided if not otherwise contained within the submittal, and the City may begin processing the application with the information as submitted. This statement serves as written notice pursuant to the requirements of ORS 22].1]8 pertaining to a complete application. Owner: 1 of . i`n _ K $i Date: Sig ature Laura Romine Owner: 2 of 2 Date: ZZ Signature Ronald Auxier Print Revised 10.14.13 kl 2 of 6 Land Division Plat Application Process (see next page for a diagram of this process) 1. Applicant Submits a Land Division Plat Application for Pre -Submittal • The application must conform to the Land Division Plat Pre -Submittal Requirements Checklist on pages 4-6 of this application packet. • A pre -submittal meeting to discuss completeness is mandatory, and pre -submittal meetings are conducted every Tuesday and Friday, from 10:00 am - noon. • Planning Division staff -strives to conduct pre -submittal meetings within five to seven working days of receiving an application. 2. Applicant and the City Conduct the Pre -Submittal Meeting • The applicant, owner, and design team are strongly encouraged to attend the pre - submittal meeting. • The meeting is held with representatives from Public Works Engineering and Transportation, Community Services (Building), Fire Marshall's office, and the Planning Division and is scheduled for 30 to 60 minutes. • The Planner provides the applicant with a Pre -Submittal Checklist specifying the items required to make the application complete if it is not already complete, and the applicant has 180 days submit a complete application to the City. 3. Applicant Submits a Complete Land Division Plat Application • When the applicant has addressed all items on the Pre -Submittal Checklist and the City Surveying Section has notified the applicant's surveyor that the plat and other documents are sufficiently refined, the applicant can submit a complete application to the City Survey Section located in the NW Quad of City Hall. • The application must conform to the Land Division Plat Submittal Requirements Checklist on page 6 of this application packet. • If the submittal is deemed complete, the City Survey Section will sign -off on the City Survey approval sheet and send the applicant to the Development & Public Works Department for application submittal and fee collection. Planning staff checks and signs the mylars. 4. Applicant Records Plat at Lane County & Submits Plat and Documents to City • After Planning staff checks and signs the mylars, the plat may then be recorded by the applicant's surveyor at Lane County. • After plat has been recorded at Lane County, applicant submits five (S) recorded, rolled paper copies of the plat and three (3) copies of required documents to the Development & Public Works Department prior to the issuance of building permits. Revised 10.14.13 kl 3 of 6 LAND DIVISION PLAT APPLICATION PROCESS Applicant submits land division plat application for pre -submittal (See Land Division Plat Pre -Submittal Requirements Checklist) City departments review application for completeness and hold pre -submittal meeting to discuss completeness issues with applicant and applicant's representatives. Applicant addresses incomplete items. City Surveyor checks application and returns comments to applicant's surveyor. Applicant's surveyor corrects plat City Surveyor conducts field check and and returns to City Surveyor. returns comments to applicant's surveyor Applicant's surveyor sets new monuments and flags existing ones. Once no errors appear on the plat and a current title report is submitted, applicant's surveyor is given ok to submit complete land division plat application. After ok given from City Surveyor and applicant has addressed all incomplete items from pre -submittal, applicant submits complete application to the City Survey Section (See Land Division Plat Submittal Requirements Checklist) City Survey Section signs -off on City Survey approval sheet and sends the applicant to the Development & Public Works Department for application submittal and fee collection. Planning staff checks and signs mylars and notifies applicant's surveyor of approval. Applicant takes plat and accompanying documents to Lane County for recording. Applicant brings copies of recorded plat and documents to Development & Public Works Revised 10.14.13 kl 4 of 6 Land Division Plat Pre -Submittal Requirements Checklist NOTE: If you feel an item does not apply, please state the reason why and attach the explanation to this form. Application Fee - refer to the Development Code Fee Schedule for the appropriate f calculation formula. A copy of the fee schedule is available at the Development & P lic Works Department. Any applicable application, technology, and postage fees, are Ilected at the pre -submittal and submittal stages. ❑ Lan Division Plat Application Form ❑ Letter ddressing Conditions of Approval - lists and addresses each ondition of approval, etailing the actions taken and current status of each item. ❑ Five (5) Pa r Copies of the Plat stamped and signed by the sur eyor. ❑ Two (2) Copie of Closure Sheets for the boundary and eac of or parcel and all common areas, d icated areas, and easement areas that are of simple parallel offsets. ❑ Two (2) Copies of . le Report or Subdivision Guara ee for the parcel being divided. The title repo must be dated within 30 days of ubmittal at the time of the final submittal. An older repo is OK at the pre -submittal s ge. ❑ Two (2) Copies of Each o he Reference Docu ents and Plats listed on the plat. ❑ Two (2) Copies of Each of th Supporting D cuments - the vesting deed (must vest title to the owner listed on the pla existing sement deeds, and documents listed as exceptions in the title report, etc. ❑ Two (2) Draft Copies of any street d 'cations. ❑ Two (2) Draft Copies of Any, New ase ents or Restrictions being created by separate document, improvemnt reemen maintenance agreements, joint use ingress/egress and utility easem ts, sewer ho k up in lieu of assessment, and any other documents that/easements ecorde together with th plat or that are required by the Conditions of A ❑ Two (2) Copieo sent Statement (Concurre cc) on the plat (to be signed by the lender priorpproval) OR Two (2) Copies an Affidavit of Consent by separate documquired from all Trust Deed, mortg e, or other secured loan interest holdersthe property to be recorded simulta ously with the plat IF any public dedicatiosements are being made and/or any o er interests are being transferred to t per ORS 92.075 (2-4). i Fol Copies of VjYetland Documents as required. Copies 9f ODOT Access Permits as required. of Bargain and Sale Deed for Reserve Strips - City that Street Tree Agreement is in Progress as required. Draft Copy of the Conditions, Covenants & Restrictions (CC&Rs) as required. Section has a Revised 10.14.13 kl 5 of 6 onumentation Deposit as required for subdivisions only. City has curren hedule and templates. ❑ Location of Any ❑ Existing Easements Cle entified wit-Ttreir-tReecorded Reference. ❑ New its and Reserve Strips Referenced in Owner Cer ' ' es of edication and Purposes of Easements Identified on Plat. NOTE: When, as part of the approval process, the application has been conditioned so that the recordation of a document is required, the applicant shall be responsible for paying the Lane County recording fee for any such required document. Documents which may require recordation include, but are not limited to: Development Agreements; Improvement Agreements; Deed Restrictions; Future Development Plans; Easements; Joint Use Access/ Maintenance Agreements; and Dedications of Right -of -Way. Land Division Plat Submittal Requirements Checklist NOTE: If you feel an item does not apply, please state the reason why and attach the explanation to this form. X❑ Application Fee - refer to the Development Code Fee Schedule for the appropriate fee calculation formula. A copy of the fee schedule is available at the Development & Public Works Department. The application, technology, and postage fees, where applicable, are collected at the time of complete application submittal. X❑ Land Division Plat Application Form ❑X Two (2) Copies of the Deed ❑X Two (2) Copies of a Title Report issued within 30 days of the date Lane County will record the plat. ❑X Original Plat on Mylar with notarized owner(s) signature(s) and signed surveyor stamp. ❑x Copy of the Mylar on Bond Paper R] Original and Copy of all Required Documents with signatures where appropriate. Revised 10.14.13 kl 6 of 6 After Recording Return To: Laura Romine & Ronald Auxier 5735 Mineral Way Springfield, OR 97478 DECLARATION OF EASEMENT & MAINTENANCE AGREEMENT RECITALS: 1. LAURA ROMINE and RONALD AUXIER, Declarants, are the owners of those certain real properties hereinafter referred to as "Lots 1 through 5", and being more particularly described as follows: Lots I through 5, ROSiE SPRINGS, as platted and recorded 20 , Reception No. and Records. Lane County Deeds 2. Declarants desire to create a Variable Width Private Shared Access & Utility Easement over Lots 2 through 5 to the benefit of lots 2 through 5 (and to the benefit of Lot t for stormwater only), and to establish an agreement regarding the maintenance of improvements located within the easement area. NOW THEREFORE: 1. Declarants hereby create, reserve, and dedicate a variable width shared access and utility easement over, upon, mid across portions of Lots 2 through 5, to the benefit of Lots 2 through 5 for access, stonnwater drainage and other utilities, and to the benefit of Lot 1 for stonnwater drainage only. 2. The purpose of the easement is for A) providing vehicular, pedestrian mud emergency vehicle access, including ingress and egress, to and from Lots 2 through 5, including the construction, installation, inspection, maintenance, repair and replacement of associated driveway and paving improvements; B) for the construction, installation, inspection, maintenance, repair and replacement of stomiwater management facilities which provide service to Lots I through 5; and C) for the construction, installation, inspection, maintenance, repair and replacement of other utilities which may be needed to provide service to Lots 2 through 5. 3. The legal description of the easement area over Lots 2 through 5 is more particularly described on Exhibit "A", attached hereto and by reference incorporated herein. The casement arca is shown graphically on Exhibit `B", attached hereto and by reference incorporated herein. 4. With the exception of driveway, paving, stormwater management facilities, underground utilities and "No Parking — Fire Lane" signs, no improvements of a permanent nature, including but not limited to buildings, shall be constructed within the easement area. Declaration of Easement and Maintenance Agreement Page 1 of 6 5. No parking of any vehicles is allowed within the easement area. The shared driveway and emergency vehicle turnaround within the easement arca shall be kept clear of obstructions to emergency vehicles at all times. 6. The easement includes the right to remove any improvements or other obstructions which may hereafter be placed in the easement arca that would adversely affect access to and from Lots 2 through 5, including emergency vehicle access, the construction, installation, inspection, maintenance, repair and replacement of stormwater management facilities which provide service to Lots 1 through 5, or the construction. installation, inspection, maintenance, repair and replacement of underground utilities which may be needed to provide service to Lots 2 through 5. 7. Costs for routine maintenance, repair and replacement of the shared driveway, emergency vehicle turnaround, and associated paving improvements and "No puking — Fire Lane" signs located within the easement area shall be borne equally by the owners of Lots 2 through 5. 8. Costs for the routine operation, inspection, maintenance, repair and replacement of the vegetated stormwater planter identified as "Planter #1" on Exhibit `B", attached hereto and by reference incorporated herein, including any costs associated with the restoration or replacement of any driveway, paving, or other improvements within the easement area which may need to be temporarily removed or altered for purposes of, or damaged in the process of operating, inspecting, maintaining, repairing or replacing said stormwater planter, shall be home equally by the owners of Lots 1 through S. 9. Costs for the routine operation, inspection, maintenance, repair and replacement of the vegetated stormwater planters identified as "Planter #2" and `Planter #3" on Exhibit `B", attached hereto and by reference incorporated herein, including any costs associated with the restoration or replacement of any driveway, paving, utility or other improvements within the easement area which may need to be temporarily removed or altered for purposes of, or damaged in the process of operating, inspecting, maintaining, repairing or replacing said stormwater planter, shall be borne equally by the owners of Lots 2 through 5. 10. Maintenance costs for underground utilities now existing or which may hereafter be constructed within the easement area to provide service to Lot 2, including any costs associated with restoration or replacement of any driveway, paving, utility or other improvements within the easement area which may need to be temporarily removed or altered for purposes of, or damaged in the process of constructing, installing, inspecting, maintaining repairing or replacing said underground utilities providing service to. Lot 2, shall be borne solely by the owner(s) of Lot 2. if. Maintenance costs for underground utilities now existing or which may hereafter be constructed within the easement area to provide service to Lot 3, including any costs associated with restoration or replacement of any driveway, paving, utility or other improvements within the easement area which may need to be temporarily removed or altered for purposes of or damaged in the process of constructing, installing inspecting, maintaining, repairing or replacing said underground utilities providing service to Lot 3, shall be borne solely by the owner(s) of Lot 3. 12. Maintenance costs for underground utilities now existing or which may hereafter be constructed within the casement arca to provide service to Lot 4, including any costs associated with restoration or replacement of any driveway, paving, utility or other improvements within the easement area which may need to be temporarily removed or altered for purposes of, or damaged in the process of constructing installing inspecting, maintaining repairing or replacing said underground utilities providing service to Lot 4, shall be home solely by the owner(s) of Lot 4. Declaration of Easement and Maintenance Agreement Page 2 of 6 13. Maintenance costs for underground utilities now existing or which may hereafter be constructed within the. easement area to provide service to Lot 5, including any costs associated with restoration or replacement of any driveway, paving, utility or other improvements within the easement area which may need to be temporarily removed or altered for purposes of, or dmnaged in the process of constructing, installing, inspecting, maintaining, repairing or replacing said underground utilities providing service to Lot 5, shall be home solely by the owners) of Lot 5. 14. Costs for repair of damage to any improvements within the easement area caused by the owners or occupants of a specific Lot and/or their guests, contractors, invitees, etc., shall be the sole responsibility of the owner(s) of that specific Lot. 15. Property taxes for the portion of the easement area lying within the boundaries of Lot 2 shall be paid by the owner(s) of Lot 2. 16. Property taxes for the portion of the easement area lying within the boundaries of Lot 3 shall be paid by the owner(s) of Lot 3. 17. Property taxes for the portion of the casement arca lying within the boundaries of Lot 4 shall be paid by the owner(s) of Lot 4. 18. Property taxes for the portion of the easement area lying within the boundaries of Lot 5 shall be paid by the owner(s) of Lot 5. 19. This easement and the maintenance provisions associated therewith are granted subject to all prior easements or encumbrances of record. 20. Should any patty be required to bring an arbitration, action, suit or other proceeding to enforce or interpret the terms of this agreement, the prevailing party in any such proceeding shall be entitled not only to recovery of its cost and expenses incurred therein, but also reasonable attorneys' fees incurred in enforcing or interpreting this agreement. 21. This agreement and the easement declared herein shall run with the land and shalt bind and inure to the benefit of the successors and assigns of Lots 1 through 5. 22. The easement expressly declared herein is not intended to merge or be extinguished by common ownership of Lots 1 through 5 or any combination thereof. [signatures on following page] Declaration of Easement and Maintenance Agreement Page 3 of 6 M WITNESS WHEREOF, Ai� the undersignctdr have executed this Declaration of Easement & Maintenance Agreement on this —5y -d -day of 2DrC-{1 2-0ZZ LAU A ROMINE RONALD AUXIEI ACKNOWLEDGEMENTS: STATE OF NEW YORK ) �I- ) COUNTY OF &k2- YA ss. lk _ ) On the day of 'y \QY t k in the year 2D2-2 before me, the undersigned, personally appeared LAURA ROMINE personally known to me or proved to me on the basis of satisfactory evidence to be the individual whose time is subscribed to the within instrument and acknowledged to me that she executed the same in her capacity, and that by her signature on the bust meat, the individual, or the person upon behalf of which the individual acted, executed this n rm tent. Notary Public Signatures �pi eta CDrYIisk Print Name PATRICIA L. CORNISH Title or Office: D b i L i Notary Pubrio State of New York j Steuben County No. 01C0627134 My Commission Expires: A0, 2,a =4 ' My Commission Expires STATE OF WASHINGTON ) ss. COUNTY OF OV6, On this day personally appeared before me RONALD AtJX1ER to me (mown to be the individual described in and who executed the within and foregoing instrument, and acknowledged that he signed the same as his free and voluntary act and deed, for the usesand purposes therein mentioned. Given under my hand this X/ � day 0479 t 24Z and official seal of , `%N%p j%V-L?s LOe ��i;� •EXP Nottaat Public in and for the StateKington ��x'•. r2 •.Oip o aaN:. (� 0/671c) V111,410695 U•;�o� NorARY 7 UBt{C Print Name '-*z SOL C9 Residing at: )-w way 98�Z3 No yso� hO �tWPSNv?x` My Commission Expires: Z� Declaration of Easement and Maintenance Agreement Page 4 of 6 Exhibit "A" LEGAL DESCRIPTION Variable Width Shared Access & Utility Easement Beginning at the Southwest corner of Lot 1 of ROSIE SPRINGS, as platted and recorded . 20 , Acception No. Lane County Deeds and Records, in Lane Canty, Oregon, said point being on the East right-of- way line of 35th Street (25.00 feet from the centerline thereof); thence along the South line of said Lot 1 East, 91.20 feet to the Southeast comer of said Lot 1; thence continue East, 5.00 feet; thence South, 5.00 feet; thence East, 23.00 feet; thence North, 5.00 feet; thence East, 23.53 feet; thence along the are of a 22.50 foot radius curve to the left having a central angle of 90°00'00", the long chord of which bears North 45"00'00" East, 31.82 feet, a distance of 35.34 feet; thence North, 22.24 feet; thence East, 15.50 feet to a point on the East line of Lot 2 of said ROSIE SPRINGS, said point bearing South, 12.00 feet from the Northeast corner of said Lot 2; thence leaving said East line and running East, 16.00 feet; thence South, 22.24 feet; thence along the arc of a 22.50 foot radius curve to the left having a central angle of 62°1055", the long chord of which bears South 31°05'27" East, 23.24 feet, a distance of 24.42 feet; thence South, 5.52 feet; thence along the are of a 27.50 foot radius non -tangent curve to the left having a central angle of 22°26'47", the long chord of which bears South 78°46'37" East, 10.70 feet, a distance of 10.77 feet; thence East, 22.00 feet; thence South, 8.00 feet to a point on the South line of Lot 3 of said ROSIE SPRINGS, said point bearing West, 38.03 feet from the Southeast corner of said Lot 3; thence leaving said South line and running South, 13.00 feet thence West, 39.68 feet to a point on the East line of Lot 5 of said ROSIE SPRINGS, said point bearing South, 6.50 feet from the Northeast corner of said Lot 5; thence leaving said East line and running West, 68.70 feet to the Northeast comer of Lot 6 of said ROSIF SPRINGS; thence along the North line of said Lot 6 West, 132.85 feet to the Northwest corner of said Lot 6, said point being on the East right-of-way line of 35th Street (25.00 feet from the centerline thereof); thence along said East right-of-way line North, 26.00 feet to the Point of Beginning, in Springfield, Lane County, Oregon. REGISTERED PROFESSIONAL LAND SURVEYOR tdENEWAL DA?E' /Z•3/• ZaS Declaration of Easement and Maintenance Agreement Page 5 of M 3 M � H12iN s �O o -k 04 � N N J O N WN O ul N 0 \\ U 4Z'ON H12iN s �O o -k 04 O O J WN O ul N 0 3 ¢�j il] O �l Q O Q\\ W N ,64'941 'Hif10S >ait2 aNw s �O In 3 ¢�j ,00'£9 1H1NON 61'49 00 9Z -' ,LL -Cbl 'HUON 1 3 3 N 1 S H 1 9£ to H 0 J O n n in co N LVA RETURN TO CITY OF SPRINGFIELD DEVELOPMENT & PUBLIC WORKS DEPT. 225 FIFTH ST. SPRINGFIELD, OREGON 97477 Notice of Operations and Maintenance Agreement Private Stone water Management and Treatment System The undersigned owner(s), is hereby given notice that stormwater runoff from the "Property" described below requires stormwater management facilities to be located, designed, and constructed in compliance with the City of Springfield's Engineering Design and Procedures Manual. Said facilities shall be operated and maintained in accordance with the Operations and Maintenance Agreement (O&M Agreement) on Fite with the City of Springfield, Development and Public Works Department Refer to said O&M Agreement for provisions regarding which lot owner(s) are responsible for the maintenance of each facility. LAURA ROMINE and RONALD AUXLER (Property Owners) acknowledges and agrees to maintain private stormwater treatment facilities listed in this document. The maintenance of the stormwater facilities listed in this document is required as part of the Development Agreement with the City of Springfield. This facility will be operated and maintained in accordance with the requirements stated in this document and in the latest edition of the City of Springfield Engineering Design Standards and Procedures Manual, Chapter 3. The City reserves the right to enter and inspect any stormwater facility located on the `Properly" to ensure the facilities are operating as designed. Failure of the responsible party to inspect and maintain the facilities can result in an adverse impact to the public stormwater system and the quality of receiving waters. The requirement to operate and maintain the stormwater treatment facilities in accordance with the approved site development agreement and the site O&M Agreement is binding on all current and fnurc owners of the property. The Agreement and its O&M Plan may be modified under written consent of new owners with written approval by and re -filing with the City. The O&M Agreement and O&M Plan for facilities constructed pursuant to this notice are available at the Development and Public Works Department 225 Fifth St, Springfield Oregon, or call (541)-736-3753, between the hours of 8 a.m. and 5 p.m., Monday through Friday. The Subject premises, is legally described as follows, Lots 1 through 5 of ROSIE SPRINGS, as platted and recorded 20_ , Reception No. 20 Lane County, Oregon. Lane County needs and Records, in By signing below, the signers accept and agree to the terns and conditions contained in the Operations and Maintenance Plan and in any documents attached_ This instrument is intended to be binding upon the parties hereto, their heirs, successors, and assigns. [signatures on following page] Page 1 of 2 In Witness whereof, the undersigned have executed this instrument on this 12l Y -j day of Ak&4_, Owner(s): Sigrratu4fX Signature 4ez4'e Print Name LAURA ROMINE Print Name RONALD AUXIER STATE OF NEW YORK ) ss. COUNTY OF On the 'rd day of Isr oxcC -, in the year 2022 before me, the undersigned, personally appeared LAURA ROMINE personally known to me or proved to me on the basis of satisfactory evidence to be the individual whose time is subscribed to the within instrument and acknowledged to me that she executed the same in her capacity, and that by her signature on the instrument, the individual, or the parsN upon behalf of which the individual acted, executed this instrument. UdJ.\yJ...- �- 1Vry\ Public Signature � Print NamePATRICIA L CORNISH 1 Notary Public State of New York Title or Office: 1 `r O�qY' .,vlp 1 i C. Stauben Counb Pb• 010.06-27,13,,45, I I My Commission Ex�ros iA. 4 My Commission Expires: I n - Z9 'ZO2y- STATE OF WASHINGTON COUNTY OF KI/A ss. On this day personally appeared before me RONALD AUXiER to me known to be the individual described in and who executed the within mid foregoing instrument, and acknowledged that he signed the same as his free and voluntary act and deed, for the uses and proposes therein mentioned. Given under my hand and official seal this ��RGN 24erZ'L day of No ary Public in and for the State o W ashingum �P.,,2a' CI ECU V I GGA l U gOS i0 '! i U' Np'(PFNO ^ Print Name eme Residing F�Er � wn�yI 98 23 at: J irCt1 W0t x �(' My Commission Expires: 01 Page 2 of 2