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Utility Easement - IndividualUTII,ITY EASEMENT (INDIVIDUAL FORM) THIS INDENTURE, made this day of , 20 ,between ,hereinafter called the GRANTOR, and the CITY OF YELM, a Municipal Corporation, hereinafter called the GRANTEE, WITNESSETH: For valuable consideration, receipt of which is hereby acknowledged, the Grantor hereby grants and conveys to the Grantee, its successors and assigns, A PERPETUAL EASEMENT FOR Sewer System and Water System, over, under, upon and through a portion of that certain real property situate and being in the County of Thurston, State of Washington, more particularly described as follows, TO WIT: PARCEL: 22730110201 PERMANENT EASEMENT: Said portion of the above-described parcel being described as follows: Section 30 Township 17 Range 2E Quarter NW NE BLA040069YL LT 1 . :TOGETHER WITH the right to enter upon, over and along said real property hereinbefore described, from time to time, to construct, inspect, repair, alter, modify, replace, remove, and update to present and future technological standards, said Sewer system. The Grantor shall not place or construct a building or other structure on the easement right-of-way. CONSTRUCTION EASEMENT: . Together with a temporary construction easement described as: Said temporary construction easement to terminate upon completion of the initial construction of said Sewer System and Water S.. sue. The permanent rights herein granted to the Grantee shall continue in force until such time as the Grantee, its successors or assigns, shall permanently abandon the same and upon such removal or :abandonment, all rights hereby granted shall terminate. . IN WTTNES S WHEREOF, this instrument has been executed the day and year first above-written. Grantor Grantor STATE OF WASHINGTON ) ss :COUNTY OF THURSTON ) I certify that I know or have satisfactory evidence that is/are the person(s) who appeared before me, and said person(s) acknowledged that (he/she/they) signed this instrument, and acknowledged it to be (his/her/their) free and voluntary act for the uses and purposes mentioned in the instrument. Given under my hand and seal this day of , 20 Notary Public in and for the State of Washington, residing at My commission expires: Accepted by the City of Yelm, Washington. this day of , 20 BY: Director of Public Works STATE OF WASHINGTON ) ss :COUNTY OF THURSTON ) On this day and year above, personally appeared before me, to me known to be the Public Works Director of City of Yelm, a Municipal Corporation, who executed the foregoing instrument and acknowledged the said instrument to be the free and voluntary act and deed of said Municipal Corporation for the uses and purposes therein mentioned and on oath states he is authorized to execute the said instrument. Given under my hand and seal this day of , 20 Notary Public in and for the State of Washington, residing at My commission expires: