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Town_ .hip 17 MOrth, ltan._ 1 w..t, W,H., described on (allows 1 !lrCIHHDfG at the Northwlst eorner of saId Block 8; thine. ...terly a1onll: the North line of Block B, .. distance of 65.0 h.t to the trtle point of beRinninll of thia ducrip_ tionl thotnet South tor" di!lt"nc:e ot 1'11.5 feet; t1Jtln~ c.ut.. distanc:e ot 71.IIi f.et; thenCe tumina" denec:tion I "'Ille of IOJo51' to the left, .. dist..nce ot 2~. 79 het; : . ~ thenc. turn!nll .. defl<!'ction .nltl. ot 90. to the ri'l'ht, . ~" "'" dist..nce ot 100 feet to thtl' C..U edl!e Of I.id Tn: Lot liD; ~'Q>' thence turninll: . de(lf!ctiOfJ .nllIe of 90. to the left clonJt ,i ':- thtl' [Ut erllle of ."id T." Lot 1i0. '" distAllce Of 16.1 hetl > " thence tUf'TIinll . deflection .n;:le of 76.08' to the leff. . ' ... c dht.nce of 139.5 tl!et to the tru<'l point ot b4A:inninl, J B'N I\'IT:\.,E~~ $HCl.rnr, .....d (,..,."""... 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Pay by cash or C7~d ~'" " CHAPTEA 8246 RCW"..'-, ch.ck10 CoufltyTr....ur.r, 0 _~ PLEASE TYPE OR PRINT CH~TER 4S8.e 1 _ WAC ~ THIS AFFIDAVIT WilL NOT. BE ACCEPTED UNLESS JTEMS CD THROUGH CD AR! FULLY COMPLETED Nama JOHN R. BURNS TON & @ LYMAN M. ELLIS & Nam. TERRIEO. BURNS TON ~~ RACHEL J. E LLl S 134 Ol" Sfr.llt P. O. BOX 193 Namll Stlte WA Zl 98376 ell SAME AS BUYER GRANTEE HEREIN PORT TOWNSEND s,... WA 21 98368 ALL TAX PARCEL NUMBERS 956100039 Slreel Clly/Slat. Zip o LEGAL DESCRIPTION OF PROPERTY SITUATED IN UNINCORPORATED JEFFERSO~OUNTY 0 OR IN CITY OF , " . .,. . " . ~ ' THIO SbUTH 50 FEET OF ;HAT POR{IO~ 't:\'F'~RAcf'N(),:13 "L~NGWE5'T OF STATE HIGHWAY NO.9, OF HAMILTON'S FIVE ACRE TRACTS, QUILCENE, JEFFERSON COUNTY, WASHINGTON, AS PER PLAT RECOROED IN VOLUME 2 OF PLATS, ON PAGE 97, RECORDS OF JEFFERSON COUNTY,' WASHINGTON, 20 20 g. PrincipII UII: 20 , 0 10rl..II.", O · 0 Ipt(H ..11.) 2 7 0 .ommlt.I., mt.i'suRER;S;~OLv" , <, t)' \ / ,:1/ , /' ,/ "~"? I o III this property currenlly: Classified or designated as foreat land? Chapter, 84.33 ReW Classified a8 currenl uso land (open apace, farm and agricultural, or timber)? Chaplet 84.34 ReW exempt from property tax under Chapler 84.36 ReW? (nonprofit organi:rstiona) Type Property: 0 land only 0 land wllh new building, O'and wllh previoualy used buildIng o SEE TAX OBLIGA TIONS ON REVERSE SIDE NOTICE OF CdNTINUANCE If the new owner(s) orland thai hi classified or deelgnated aa current use or forestland Wlllh(oll) to continue the class/f1cellon or dulgneUon, of such lend, the new ownerCa) mU'1 algn below. It Ihe now ownor(.) doCea) not'doalre to continue auch clalSlflcaUon or designation, all compensating or addlllonal t8X calculated purauant to RCW 84.33.120 and 140 or RCW 84.34.108 ahall be due and payable by tho aaller or transferor at Iho time of I8le. To determine I' the 'and trlnaloned qualilles to continue clasalflcatlon or desIgnation. Ihe county a.lOllor mU'1 be con.ulted. All new ownors mu.t sign. ' Slgnalure(a) Thlaland o do.. . & 0 don not qU~Ilf)' for continuance. Deputy A.....o' Oa.le @ , The following optlona, que.llon. ar. requ..t.d by ACW 82,45. 120 I. properly Illhellm. of ..Ie: - a~ :~~~::~~;Id.rfy. dlllblllly, or phyalcallmprovemant 10 b, Do.. bwlldlnO. II t!)Y. have . hta' pump or aolar 0 h.allng or cooling ')l.t.m? 1 C. Do.. thl. Conveyance divide a current pltcsl of I.nd? ,0 d. ~::~;.Ie lnc!l,de cYffln1 crop Of merchantable 10 YES o o o .0. FOR NO o Ducrlpllon of p'or.cinel proporty" Included In ealeClurnllure. ap. pllancea, etc.) o o o If o~~I~ptfon claImed, oJtpla/n' .. 1 Type 01 Documenl c;TATtJTORY WARRANTY DEcO Deleof8ale ?/l'4/R4 Grou Selo Price 11 $ ? 1 r:; n nOD ~:::~~:I::I:P:r~eCdeduct) 21 :;t. :> , , u u . u U , EX,ClaeT~x Slet~~31. $, XYA'<t5l'R ?r:;1 4 . '. local41 "~',' '$" .... ~~~'17t\' Dellnquenl Penalt)' 61 $ Tolal Tax Due $ (SEE '.5 ON REVERSE SIDE) ,)J.U.;lU (!) , AFFIDAVIT I, the underelgned, beln~ fir'" -.worn. on ollh atate that the foregoing In. formallon 10 Ihe belt 0'. my ,~nowledg. la a,true and correct Itatemonl ','0'. tho ficla pertalnlng.l.lo' the: Ir.n',,.,, '0" Ihe above descrlbed( reAl oalale. Any peroonwlUfully giving ralll8ln"ormatlon In thll affldavlllhaU be lubJecl to lho PERJURY lAWS oflhl Slate of Waahlngton. SEE BION REVERSE FOR PENAL TIES. P Slgnalur Sub8erlbed. t ,,~,'Idl.o ".' ~I,).r AI... ..,..... NO .. DOl. cpnv.lyanc.'nvolv.",a4I, PIrtle".. Inll,..t corporale allm,t.., ralaled pI"I.., trul', rtellve"hlp'C)f' ~n nlata? r. II the Orlnl.s acting II . nomln~or a ~d piny? _, _ NO 20 20 .os ,0 ,0 I, r.' Iv ~. 't"' '" '0 :I 0 c~ndom~um . 0 IlldUllrl~ .8 0 moblll Hplnl .... '3 0 rlcrelllo, IS 0 ro.ld.nU, o o 11mb.. t- t. ~~. C?l 'j C;l ( ) ....'I,J.w "\J- -_ . ..... C' C':. t;.,,; I .~,~.'~;~ " ~: R . t9OU~"X ASSeSSOR ,e THISAFI='IOAVIT WilL NOT BE ACCEPTED UNLESS ITEMS Nome N. Douqlas Vliet ~ ~o "'~ ~~ ~ Street Cily State Zip i) NEW OWNER:S Name Linda M. Vliet PERMANENT ADDRESS FOR ALL PROPERTY Address same as above TAX RELATED CORRESPONDENCE City/Slate w ffi~ Sll ID~ Street P.O. elly WA Zip 98376.., ALL TAX PARCEL NUMBERS Zip ) LEGAL DESCAIPTION OF PROPERTY SITUATED IN UNINCORPORATeD JeffRrson COUNTY D OR IN CITY OF The Ho1:th 80 feet of the South 130 feet of that portion of Tract No. 13, lying \'lest of State Highway No.. 9, of Hamilton's Pive Adre Trasts, as per plat recorded in Volume 2 of Plats on page 97, recorqs of Jefferson County; Situate in the County of Jefferson, State of Washington. ) Is this property currently: Classllled or designated iis tores(l.(d? Chapler 84.33 ROW YES NO / o ~ Classified 85 current use land (open 'space. larm and agricultural, or limber)? Chapter 64.34 ACW o ~ Exempt from property tax under Chaplor 84.36 RCW? (nonprofit organizations) .'0 IjfI Type Property: 0 land only 0 land with new building, :KJ land with ,P,~~VIOuSIY used building SEE TAX OBLlGA TIONS ON REVERSE SIDE NOTICE OF CONTINUANCE If the new owner(a) of land that i. classified or designated as currant'use or loresl land wlShles) to conlfnuo lhe claulflcatlon or designation of such 'land, the new owner(l) must Ilgn below: If the new owner(s) do(el) not deslro to continue such cluslflcallon or deslg'nallon; all compensating or addlllonal talt calculaled pursuanl to ACW 84,33.120 and 140,or ACW 84.34.108 Ihall be due and payable by the soller or transleror althe.Ume of aale. To determine II the land Iransferred qualiflos to continua claJlIl,lcatlon or designation, the counly auessor mu.l be consultod, AU new owners musl .Ign. '... - Slgnaturelsl , ' This land 0 dots 0 dOeS not qUln;y lor eo~lInu~ncI: CIPUty AJleslor -Dill. Th. lollowlng optlona' quo.tlona .r. requ,'II8d 'by ACW 82.45,120. I. plopeny 111hl tlml 01 lilt: a, SUbj'C! 10 .let.rly, dl.lblUty,'ot phylleallmpro....m.nl ...mptlon? b Do.. building, 11 any, hi.,. . h.11 pump or 101., "alling or cooling IYIl.m' c Don Ihll con...lyancl divide . current puce' 01 laM? d 00.' .... Includ. curr,nt crop' or morchantabll limber? YES NO ,0 ,0 ,0 ,0 ,0 ,0 ,'0 ,0 ',' o Description of personal property If Included In sale (furniture, Bp~lIances, etc.) If exemptron claimed, explain PTnpprry il i ~ri c: inn ; n disBolution~of rnarriaqe. JeffeBson County Cause i 106~~ If transfer Is 'a gift,' gilt taxes are due and payable to State of Washington by April 15th 01 the,fOllowlng year. Type of Document Qui t claim deed Date 01 Sale -Oec:embe-r 1-9-8-2-'- ,/- ,-<.~, Gross Sale Price 1/ $ 'Personal Propeny (deducl) 2/ $ Taxable Sale Price $ '. . 1 % Exclao Tax 31 $ Delinquent Penalty 41 $ Total Tax Due $ no. 00 (SEE 1-4 ON THE REVERSE SIDE) AFFIDAVIT I, the undersigned, being Ilrst sworn, on oath Ilate that tho lorogoing information 10 the beat 01 my knowledge Is a true and correct alalement 01 the facti. pertaIning to the tranaler 01 Ihe above described real estato. Any. peraon Willfully giving lalse Inlormatlon In this affidavit ahall be lublect to the PERJURV LAWS 01 thO Stale or Washington, SEE 61qN REVERSE FOR PENAL TfE~. .'/, t-- .-;:..L1ft / /) I,' {(.<( Slgnaturo poc : rantor r.ntee genl or ranlor rantee Subscribed and Iworn to me thl- .' f"/ day ol~~ 19;-.J.. ..,~t 1_ :- " l(j..(', . ;.Nolary Public In and lor the Stale of residing at I -t..f7 , /.'_I"':i"'i';f?:7'~1~ ;//"" . u . .~ - , . ". .:' '\.'~!I/' ,''': YES NO e. Doel 'conveyance Involve a trade, p.rtla I Inlerell corporato alllllatel, relaled plrtlel, IrUlt, t 0 2 0 fecelveflhlp or an .lllle' t, ~an~; granlll acUng II . nominee lor . third 1 0 2 0 g. PrincipII UM: o adrlcullural 4 0 apt (4.unlll) 7 0 commercial o condominium o o Orecrculllonal O~elldonlllll D'lmb~;''''' Indullfial mobile home FOR TREASURER'S USE ONLY " . )0 / \A ..tt~' ~,~~ f. \ 'l~~ . ...., " ~ ,.. " ~ ~ ~ ~ I .... I I Pt.,? ,. , 0- s:. ,,8,~ll _.. - \9 "1. ~ '?> 'oN ><~ 8l:~ ....-. \:S' - . " ",r ," ,,' ::>,'" ':: ..,'...':' ,:'.." '::. ' , .', . ., " .' ,,' .,: 7""1,."" '. ',...' . -, .' ,." ", "':, '.'.' .', '.'> '. , .:. .,:.' .' .."..,.. . ,.... '. , .'." " :,',' . , , ' .'. ',;.', ..' :," ", ';, , ' ".',.: ': ,': ",. " . .. ....; .' ,., ., "., ,: . ' , , .,' ".,.", . , ,.' ,'. ,:.-'. "."',,. '),,,,,J.~.s:C?_, '. ~Old~M",.i:"I"-3~..:;- '" ,', :,', , ".':, ': ' ':.. '.'.'___.' ". JESq<IP'\II~ P;t )0... 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Dollnrs ...J, I " alld,~lsO of benefits to (Ieel'ue to,...,-_..__.._...,_.._..,..:....J,I/l'ensOlt,d ul and e,'tnblisltill,q a pllblie I'on,l Vii ,> I" ' ..'~. , '. . ~ "> t"!O"!!h.,:,..,_..,...--.._-'-_......_-:I"'Opel'llI, andwltieh i8 IWl'eafte",. '&d, eonvei/..._, relen,'e......., and quit, I :: el~i'm,"..to tile Conlltll of-,J..e,t:!.,e.r,S,Qn_"_"~______,._,n.._......,_,,__":"...Stole of,Wn811in!/loll, for u.seat the i Pllbllc'torever, a8 a ,mblie road nlld ltif/hway, ail inlere8t ill tile fOllOl,'ill,q described real estate, viz: ! :.~ ~~~?:.~!:~;-~ [,~' ~~~1',~,:"~ ,~'- .:1 A,t,,. of 1 ~d "foot wid. of tho Woo t .<do of ,,, N"':~,,~~J' "';";';;';~~"=~"~b~~"~""="'~~~th R~eet, V/.lJ; .'} ., ... . - .. "I' ----.- ~. .- _. -... I ':":..~,~ ,~.~t~'l'-^~~;';'~ ': .:":', Irfif!::! ~ ,', '".' .' ... ,,' , ..-' , '" ,:", '.... . .'.',,:,., :"',",'.:.' '.., >, ".. >, "", . :';. " .: '.', ..' , ...',. "",' ,,:,..,;,.,:,. ','.,' ,:,' . ...' ,,', '.'. ",.,;'., ,',' ,I '..',,', ",.' 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' " , , " . ai..,~r.~J.~:~h;~tOI1~ .........."''':'' } 00, . , ,~_:J..J!!::!..dall of...,-,-..~~];b,_......,-,-,---, 19iJ.3." before e, a Notary Pltblie i" .: '7'f1or the State of lVaB!Mll!J.!9ll, dltT!I eaIll7~/fand, Blcorn, pers01lll111l camc,.... ..-, ......-.......--..-....,...--.. ~_~..~.,' !.,-A.:..._..._..... ................._......."""...... ..to IIlC T"IOIC1l to be the illd,ivid,uaL.,.s described, i~ alld_~_e:rccuted tlw withill illBtl'lllllCllt alld, ockllOwledlled, to 'IIIe tha~,...Billlted alld, sealed !11C same ~M.fre() and volltlltary act and dced for tile 1lSCS and 1lurp08CS therein mentioned. , lVitlleBs mll/'and, alldogieia! Beal the day a::..l~:v,e written,. ..'.........,-_ . i .;]..'t)tnf'JI "lIhUtU,uIf"J.f'.:f' thlJ BtahHlf W ~ i J I ~ - U ''', . \\ ".::.."""~l.i"ill.~~ , ~ I ~ ~ ~""~]' ~ ~ ~ ~ 'I' ~..... ~ . .8 ~':'; ~;; l ., r:::. ,,~....... ~ '-, ~ ~ ;1 ~~/~ i'~J~ ~'~~\ ~'~:j.. ~ ~ ~ ~ B ~ ~ ~ ~ 1;' ~ ~' <i,~ ~ ,i.J I~" ~ 1.~ ~I i!J~ ~~g~ ~ ~\ II ~ I ~ ('( ~ ~ '~~I ffi ~ Ol .l! ~') ~ It ~ ~ -4l-g 1;' i ~ ~ ~ I: ;1 ,- ......"'0<"...... ".,,_,;-.,'....--, >~."'.'''''"' .~'"' ,..,. _'""~'." .... .,.....,~"".. . "",.-..." ~ ~ C> ... >:x.. 1 o ~ ~ ,) o ,," 04~ . . I ~ ~ ,"; . '::':'. ' ...." .',":..." ,:':,.",:",::.,.' ',,', ' " ' .'" " ',' ,,'" ',.,." ': .".'.' ':," ' " ."., . .'..' .' , ,'. . ','.. : ,: "":'," ,,: ',., "" .:,::. '. :', '" ' ,,,.., ", ," .,",': ' ,"" ","^'."i, ;',,' , . . ' ", .. . ,.:': :.i" . ".,.' ",'..'::; ..',., .' .', i,: '.: ";" ',' . '. ," . :." "<,.' ".;", , ,'. .' ."..'.,,'. .". i':),:, , .. .,'....,..,.,.':'.".:,,' ,'. ""'.' ';, --:-. ,'. :"'," ..,.. ,',."".:' " .: ,.". 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"'..........'." ,... ,:,/ ' QUIT=CLAIM DEED ~lt~ ,qra n tor.a-_Mltcrcill_..._-~--::.sw.a.n_.1:!~.firen.....a.nd.._._.._.....Ar..;n.a....Ean.s.en........._...... I :, f:' ~ h 11 I: I! I 11 ~ ~ I, I' ~ 1 ~ I: ~ ...---'--,---__.h.t.\!il bl,'.!l,~L,@_g... wiK..~_.....,_..,_,..._............_.._.........._..___..,...._..........._........................,........_..........._....... ! :> I' I tor t~e cotl-sidcrlltion of__.--O.lliL.__._:--:_.........____._....._.........._.__.___...._._.....M"....................._.................." Dollars and. ~l.ao of benefits to accrlle to-..--..-th-atrr____:__b.lf reason of ZU,1IinH out and cstablishillf! a public 1'o~d through.....--..-thaix....._____._vrolwrtYl and which. is hereafter desc,.ibed, convcll...___, -rclea.<w...__. muL quit. cla(m_._to the OOUlIt}f of-~.-Ja.;r.:I..e.':;.:aon.~.~__.._.:...._..._~.___..._.__.__.__:....Stoto of TV(l[illi'1lflton, fOl' use of the Public forecer, as a pUblic road and hi.'l~tway, al~ ilttcrost in the fol101dll.'1 described real ostate, v;z: :" i The No:tth 40 feet of that'paxt ';;::';::"WW,,~y.1pg..wes~,of State HOad lIo. 9 as ,!"'., ,'~' ,';::;;;'H):j;hl'tc..ye April 19,1932, ''?J~ ;'h"- 11/);',,;" ',' , , ". "rn"jl$;t.c,-,. 'i',., of the NW SW Sec. 13 T27H R2W sho,\~n ,by plan ,~u.PP:r()vad; b~'l"'!:~,:::;~' ~ :,,:' '. '- . ~ .w.:..:.;~"'..'W~,i~_~i<<:'" .l.;:t4,. _:::-~"",~~'~I-i' .:' ~~:fi:!i'~'FI'!!ll~"'..'\7'1'(!ik<:'''f'~~",.. " ~~~it{7 r.~;~. .L~~>~);'" ..,'~~;,: ' . ~.;. ',~ '~., '."\.~'.<. ! ! ... 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"""- --_"-_-_I.~. ,~i_-r-__-_-_ -__--_"_-__-___--_--___._-_-.-__._. . -"- --.__C2~d,v.€.z.;._!'_E _ _.27,&;-_ _ ..r.:~q,/___ Sl.c. - ---------.---)-----------------.----- !! --'"-. _.~_._---_.._---------_._-----_._--- .-.-..- -----'-----------.------. ----------.------- ---- ------II-----------------_.~ . --------.------ ---I!-----..:....._--~-- ---~~~~=---=--=~=-===-== ~-==~II==~-.---------_._- ---- --- --- ----~--:----~ --- I . ________ _ ____ t ! ----,-- -:-~-:-- ~-~-:----;::--~ T ---{~j r~R! .-- __ __ j-~--~= ~~:]~_~~!i______________~=_-= ~__ I I Petition lllU$C b~ si~nt'd br :It IC;lst Ten Householders miding in th~ vicinity where uid IOJd i, 10 be bid out. . .s "2 Z ~ ~ .. 0 . ..... ~ I-< '0 0 :i j ~ S " U g ~ r. ~ 0: . ~ ~ -il d II 0 ~ ,. ; '0 u 0 0 .; '0 U. Ci ;-. 3- ;; .~ r. Z '" ..1 ~ 0 i 0 8 0 r. C ..... I' I-< " ,... ! .s g c ..... .. " 0 Ul .!1 0 " p.. U 0: "" .. 1- 5\1". ')46' V'h . I. U ,r\-,'*h... I ffi , ~: tt::l ~ I.&.l =-: ~1 ~: ,,c Q ...: u: ~: ~ ~ 0 II ::'J ~ ::> ..' '" u ,.. ~. ~.. ~ -l "", c:.J .... ~' to') ~ ~ 2 ..... ~ . ;; . <:: -~... ~ ". ;" ...:......':... :.,.".' .... ' '. '. .. : . . ,;. '" . '.' '. '" '''. ','-.. ", '.-:.''- .- .'. . . . '. . .- ....,..'.-.. .. . .......-. . ,,'.,,' '..,...'. '.' .." '.' :.d:." :~'.'.' .:,..... . ... "". ..: >. .., ,.' '. ;..... . . :..... .." ,.' .,'. .... ",' .:.'....:, '-. '. .: ','.', .. '- , '.... .,.'. .: -' -' ' "'.':' ,..' . .' .. :.. ;. . ,.-"..' . '. .' '. . ,..... ". .-. . '.: , " :., .:".-' '. '., ........,.- . .... ...:: , .. ..., .: ..:.: .. .. :.'" .,..,........; " . , ..- ..' .; .'.' ;C. :' .., . ...,: :r . .. ',. .'. .'. ';, .- ,., . '. ". .. fIi_= I ~<==t'l;l ARLINGTON /~~' TACOMA (I---iC OLYMPIA LONGVIEW fie ,::ti'.:.4 CASCADE POLE COMPANY P. O. BOX 1496 . TACOMA, WASH. . 572.3033 /-, . -r1 /"/-. i (" ._. . . .'-' .- ," I-ij c Rail Water Truck rp:,~ t~J a <? ;/J/ vi' c!zd!.()--/" ~;-c~ f}j"~r J Lois /0 '7-/1 f? I./xrt' / L b T r 3 W/1/1L"rc ;4;4 ,('v/:S- 7 t...' 'I tfJ U (:J {'..u- r;" <,,~ t ;9' //'/;'1 /'f I U....r, , 1Y'f a::L C"''''"l.' 1','''1.1 op,'" 1 ,I". ....I! 1'(l".~"H' r"',llll"'''I\ \\""1..." fl,',II;,.,I.I' Drl"I)I", f" 1'",,'\ I'"", 1',1>11'1 L',rlll,,'J Ttl". "T'mbfJr Conserving by Wood Prascfving" ,. ". ': '. '. ',". , '-', :.., ..' "'. '-,:',,; , .... :' ' . .. "" '.'. '-', ':" :!":""::' :'.'.c:' "','.: '. ,'., .' ,'. '.', --::' .' ".:. .!', >' .......,....... ',' . .'. .. ,... . ,:, ',', "'.',' . .:' ., ..... .' "'." . " ". ..', . '.: ::..' .. ' ..... ;:" ':'. ,,:. '.-:',,'- ":, / " ". .' . '. . '.':... " ,,:. ".,,: .'. '.....- :'. .::. :. .; ',~,.'. ' " . ,""', \~,. <.,. . '," .... ',.".:' ,. ' . . "': i.', ..'," ",' .":'- " "./, " ","', . ',' ;:.' :'f! i!, '"l ,. . ",'.," ';..' , ." /'~:. . '. '.' . ". . ::. ; ,.... . . . - .:. ' .,c. ::_: - . . ..' .' '. . '. . , '. .... .... ." ". .c. .... '.' .,. . , .' .'. :-,.', . . -' .... . . '.. . ". . . , . -'.. -,.; . .... ".'. 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'. ; .. : '.- .,. . . . .'. . .,.... e 8 i'.. :.. i......:.. , ..' /71 ;L.--7, Ph:. s : . .: : 8- - 1G,-?9 Ik/l/f) /2.JU:" /rc-u lJ/lbl DJS6 . &t1~ "'''/-/V/s 7D .k:A.ltle,. tM.I-)/9/' C AA./ g,6 OCYJi!' 7U /rl?/iI?O{/6 1"1..e d7; ,c,c0h1 /lli4G,(/OL-IA -6f"/9S7 /"0 fedJ"';" eo)''''',., 6/76 Ocmv's /'/'-U'j t-Un.v7,; TO .(Jc:uu~ 8<<r S-",Y-s 3d; Tl?L{uc.:r crJ-v} G€l ~Rc.'''''D C6IZAJG~ ! . ;. . . ;" . '" .', : .' , >'. (. . lv. I~t?~i':;.elc.j<.r By THS O'ECTION C0/cNt>/"O.. .., :'.. .; \ . .:'- ....: : ." ,,': ';'.{' /' ".:.: '. i, .' :/<'.' . . :<. :, .... ':,':' .; "'-kq : :'-',:,.:"; I' ~.. ,:. ...... l~;;",,('t"'''1 i .. ....:i., ." ,". ..:. '. , ....., , .. :,i ':.'. i,'. ..... .'. .- .' .. .' .: , . \'. .... . ". . ,.:.'.. '.' ,'.' . '., i ," '.,,'.,':~ ':: 0/2, Alo",,;, IS, '. ,-'. . :i":: '. , . .,i'i':' :5? /L- s: ,&()?,",,-,r/j,JV S&/7Tn:~: wI! 98118 iFT"'~~q.t ,,, CI. \ - \C\..l\rl- <..\ \l"" t :j:cl, ~'tt;-ry>" H\4..~ lLO I \ ~ k .-- .~ <"" I I I . ' 0,U.., CO r-v...~, I -, ,<>",-\C\ ".,..' ,10 \\\\,,-, /~ 4clndc'--t-<l-;, :<!~~~Il~ .,' .... ," -'i, .,.,:". ..... ,',. ",:.:.,.,., , " .'i. :,' . .', ": ." ',i, ... ," .' .." .:" --. "'. ',: ...'...:.',..'..' ... "'" . """i ,,\.',/ . i" . "". ,:.:,' :: .,. ...., ;,.' , ", ""','".:",'.' '.,.... '. '. ,: ....',.. ..' '. . :'" " . ' '. . " ".': . , ,'. . . J , .',' .,........:. " .', .' i. '. ' . '. ',I :.. . ':,': ..... . .. .'.' , .: .:'" . I '.." " : '.... .',;. .... '.:' ~... 2 3 4 5 6 7 8 ,. 9 10 ' 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 . . --- ..-<: t tJ '.....-1' " _,,,,,)..,, r \~.~:,~~~"_ CLAIM FOR DAMAGES TO THE BOARD OF COUNTY COMMISSIONERS FOR JEFFERSON COUNTY, STATE OF WASHINGTON: PLEASE TAKE ,NOTICE that in accordance with Chapter 6.45 of the Revised Code of Washington, the undersigned ,hereby presents you with its claim for damages against Jefferson County, state of Washington, with the information required to be given byR.C.W. 36.45.020 as follows: 1. That this claim for damages against Jefferson County, state of Washington, occurred on the 9th day of November, 1970. 2. That the place of t he damage was at the Paradise View Estates, Jefferson County, Washington. 3. That the cause of damage is briefly described ~? follows: That workmen of the highway department of Jefferson County, while engaged in highway maintenance negligently ripped up, destroyed and caused damage to the wator supply of the claimant. 4. That the amount of damage claimed is in the amount of $262.49 as set forth in the statements attached and made it part of t his claim. 5. That claimant is a municipal corporation of the State of Washington having its principal place of business at Route I, Box 422B, Chimacum, Washington 98325. JEFFERSON COUNTY WATER DISTRICT NO. 1 By ~:...... r ill \.. C. t-ll"', Secretary . 2 3 STATE OF WASHINGTON SSe 4 County o~ Jefferson 5 6 DOlHR CARI,SON. , being first duly 7 sworn, on oath deposes and says: That she is the s ecre- 8 tary of the above~named Water District claimant. That 9 she makes this claim for and on its behalf and is author- 10' ized so to do; that she has read the foregoing claim, 11 knows the contents thereof and believes the same to true. 14 15 16 of 17 ..,,:.~ 18 19 20 21 22 23 24 25 26 27 28 29 30 v/~~ ~ ,,/ to before me this;l'~day , - AND SWORN '17/ ?G. 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