NO· tl'Yoife: 1cfu {'- S· ·/3 ?' LATA .:f,'intranet.ci.moscow.id.us/records/Recorded Documents/558487.pdf · 139•, CERTIFIER (Cl'ltc:k My one, bu-.d on official c:tiPI r lhit

558487 NO· --;;-:;:-:;:;-;r=-=�=�-­AT TH E REQUEST OF:

tl'Yoife: 1cfu�{'-� S·�·/3 ?'�

PERMANENT PUBLIC SEWER EASEMENT LATA����.:f,'��� FEE$ � B'r'.

THE REV. R. A. PETERSON and GLORIA JEAN PETERSON, husband and wife , whose current address is 918 North Cleveland Street, Moscow, Idaho 83843, GRANTORS, owners of real property affected hereby, in consideration of one dollar and

other valuable consideration in hand paid, does hereby grant the CITY OF MOSCOW, a municipal corporation of the State of Idaho, 206 East Third Street, Moscow, Idaho 83843, GRANTEE, and its agents and assigns, a non-exclusive permanent easement and right-of-way in which to construct and maintain a public sanitary sewer including the right to enter upon, occupy and use property located in the City of Moscow, Latah County, Idaho, to wit:

A twenty (20) foot wide public utility easement situated in Lot 1, Block 3 of Thatuna Third Addition to the City of Moscow, Idaho, the plat of said addition recorded in Book 5 of Plats, page 6, with said easement being more particularly described as followings:

The easterly twenty (20) feet of said Lot 1, Block 3 Thatuna Third Addition to the City of Moscow.

for the purpose of constructing, operating, maintaining, and repairing or replacing said public sewer by the City of Moscow or its agents or contractors or franchised utility companies.

GRANTORS, their successors and assigns, reserve the right to improve said easement area as long as such improvement shall not unreasonably interfere with the construction, operation, maintenance, repair and/or reconstruction of the public sewer. GRANTORS agree that they and their heirs or assigns will not build or place any new encroachment thereon which will unreasonably interfere with the right of the GRANTEE.

The GRANTEE, its agents or transferees, shall have the right to perform any maintenance it may deem necessary or wish to exercise in connection with the aforesaid public sewer (including, but not limited thereto, the right to make necessary repairs, alterations, and removals or replacement thereof). Upon exercising these rights, GRANTEE shall restore the property to its prior condition. GRANTEE is granted the

aforementioned rights, together with the rights and privileges of ingress and egress to and from said property for the above stated purposes.

It is expressly intended that the rights, burdens and restrictions contained in this Easement shall run with the land and shall forever bind GRANTORS AND GRANTEE, their heirs and assigns.

IN WITNESS WHEREOF, GRANTORS have hereunto set their hand and seal this

/ day ot/777 ,2013.

GRANTORS:

""Vec.eg::ied-� 4-Jladt�. REV.R.A.PETERSON �� efuoipyu , GLORIA JEAN ETERSoN

PERMANENT PUBLIC SEWER EASEMENT Page 1of2

ACKNOW LEDGE MENTS

STATE OF _������-SS

County of ________ _

On this day of 20 , before me, the undersigned, a Notary in and for said State, personally appeared ev. R. A. Peterson, known to me to be the person whose name is subscribed to e foregoing and acknowledged to me he executed the same.

IN WITNESS WHEREOF, I hav hereunto set my hand and affixed my official seal the day and year herein above ten.

(s al )

STATE OF :i:,'a(� kz:> County of k �--t c...... k..__

NOTARY P U B LIC for _ _ _ _ _ _ _ _ _

Residing at ____________ _

My Commission Expires: _ ______ _

SS

On this {2"-t day of M<3Cef , 2013, before me, the undersigned, a Notary in and for said State, personally appeared Gloria Jean Peterson, known to me to be the person whose name is subscribed to the foregoing and acknowledged to me she executed the same.

IN WITNESS WHEREOF, I have hereunto set my hand and affixed my official seal the day and year herein above written.

�� �B LIC for ;f/�6 Residing at Mo..! C.Ol,..V. :=?P I

My Commission Expires: I Z/$/Z,O/B � I

PERMANENT PUBLIC SEWER EASEMENT Page 2 of 2

_5_5_8487

n'PaOR

PRINT IN

PERMANENT

BlACl<INI<

OO NOTUSE

FELT TIPPEN

ro• INSTRUCTIONS

...

HANOBOOl<S

STATE OF IDAHO 55848'7 IDAHO DEPARTMENT OF HEAL TH AND WELFARE

BUREAU OF VITAL RECORDS AND HEALTH STATISTICS State of Idaho

CERTIFICATE OF DEATH oic.z:.:""'�t!��=:!,�Jl.��:r��l�����,... Local R9g No.

( 1.0ECEDENT'S LEGAL NAME (Include AK.A's if anv) (Fimt, Middle, Last, Sufrrx)

f; I ROBERT ARTHUR PETERSON

� .ill,. AOe.4 .. Ht errthday Ab.UNDER 1 YEAR c. UN Manthe : Deye Hou� � I 86 (Yo1<1) �'1 .. RESIDENCE· STA TE OR fQRl!IQH COUNTRY

�I IDAHO :E 7d. STREU ANO NU DER � 918 NORTH CLEVELAND ST. � 1.MARtfALS ATUS.t.TTMEOf EATll "-i

0, OATC OE �RTH {MolQ ... IYQ 0611211926

LATAH

3. SOCIAL SECURITY NUMBER 12. SEX

MALE 477-20-6596

6. BlRTHPLACe{Clty ani:i 51•1•. T1Hfltol)', orFor•lQn coumrt) MINNEAPOLIS, MINNESOTA

7o. CITY OR TOWN

MOSCOW e. APT. NOo f.ZrP CODE 7g. INSIOE C

LIMITS? 8384J �Yaa D No

9.�-SPOUSE'S NAME (11 �·. O,\o• ft!aldon niuntiJ

GLORIA JEAN HENDRICKS � 181 Married O Marrlid, but uper1ted O Wdowed O DivorCed D Never married O Unknown

•lili'li!ilil. ffo, ARM�g' u.a. , •. FATHER"S NAME: (F111i. Mlddl•. Utt. Sumil b. BIRTHPLACE (Slate, ierrltory, or Foreign Country) � FORCES? ARTHUR FERRIS PETERSON ]! 181 Yeo

MINNESOTA erntory, or ore1gn ountry)

MINNESOTA � 0 No CLARA DAHL llmlilill�· 0 ll<. INfORMANT'S HAl"Efl't•Ur!><lnQ z GLORIA PETERSON

1Jb. Rl;lATIONSHIP TO OfC!OENT Uc. MAii.i� ADDRESS (strut and Numbet. rj, State, Zip Codti} WIFE 918 NORTH CLEVELAND ST. MOSCOW, ID BJ84J EEll:mliil':l.� . , .. METI<ao OF OlsPosmor

� � Burlal D CremaUon 5, Pt.Ace OF OISPOSITIOlll (Ntrn• •nd'

ct•m•!OfY, otr!er p:11:c1) '1B. NAME AND � ADDRESS OF FUNERAL FACILITY

� 0 OonaUon D Entombment MOSCOW CEMETERY

O 0 Removal lrom Idaho

:IE 0 Othor (Sp•o'YI MOSCOW, IDAHO 83843 •111. SIGNATURE OF F\INfRAL SEFMCe UCEHSEE OR PERSON CTUIG AS SUCH

•ELECTRONICALLY FILED: DAVE L. HUTION

SHORT'S FUNERAL CHAPEL 1225 EAST SIXTH STREET MOSCOW, _IDAHO 83843

1711. LICENSE NUMB.ER (Of ktnue) M0651

18. WAS CORONER CONTACTED DUE TO CAUSE OF OEATH7

0 Yee No

• !IA. IF OeATit occu'�R�R�E=o�,N�A�H O�S.�Pl�T�Al.:�- .�,� -.. �, F�O�eA=TH=o�c�cu�R�R�E�o-":=�;������:�HAI< ... MOSPITAl.:

!10 Inpatient 2 OERIOutpeHent 3 ODOA 4 OH011pice racllity s m "�home/long term care fedllty eooecedonl's homo 70 Other(Spedfy) __ _ _

I• 20.FACIUTY NAM! (Ir � 1o1 • 'UHtand l\lm'lboJ) • 2t, CrTY. TOWN, OR LOCATION OF DEAft{. AAO ZW C:OD.E • 12. COUNTY OJ= DEATH

GOOD SAMARITAN SOC. MOSCOW VILLAGE MOSCOW, ID 8J843 LATAH • 23. DATE OF DEATH (Mo/Day/Yr) (Spell month) 24. TIMe OF DEATti C2CM 25.

DATE PBONOUfrl.'(';EO DEAO (Mo/Oeyfr'r) (SptiQ month) 26. TIME PRONOUNCED ���) September 7, 2012 11:55 September 7, 2012 11:55

71. AUS! OF OUTH iPAAT t. En!tt tfie � -diuu••.Jn;.ul••, or-eoni�im.-ttnu dtlfldt aln9d th• autf\ .. DO NOT tnrer 1•mii* t'ietn 1� 11 catd1c

I Approximate lnte1Va1:

1trrHt., rHpfr•'°'1 IJIHI., OI \'.-n.ufe\nlt tibrilUlfon �1hou1•!lodl!'llg11'1-• ellatogy.DO NOT ABSREV\AT£. ENtr oriy 0-1\0 c;.11mtt on• Jn1� Oneet lo Death

1:,1:;,��T!,�:t!,• 1�111 , .£ti�tl.l!<...G.MFT 1.tjil.QILQ_t±/§.!.l.P..AC..\!IJ;J!A9:E.8!P.L l;.�!J�Q=C=A�R�D=l�TI,S�------i !.Y!O.AB_l!. ______ _ 1 'u"-�nv.,, dHth) OUE TO (Or ... COfla•�ne. oO.

b. ·--·�·----····-- -····-----

DUE TO (ot aa e eonsequence of):

i :

£ :Sequenllally llat condlllon11, m !Ir any, leading lo the CaUH o ;111ted on line s. Enler lha Q '.UNDERLYING CAUSE

·LAST �d lseaae or injury � ·:�:�:���:��:lh;ven\1 ---------------- 1 -------c, ... �-··-····· -·····----·----

DUE TO (or H a consequence of):

I d ____ ,,,_,, __ , __ • ---- · ·------·--------! .

� "'P"41i=ri""1.-.e,,=1• ,...• '""0 111""1"'"1 '"'• ·o-rn"'n-11.,.n 1""c""oa"'dj!lort>=-, .. =u11w=11"'00"'1""0 <1ii=11""0 "'"""'-.-"""''""'•-•U111""'"ng..,.1o"'l/1 -•.,....,�,,,,�,.. -ca-v•""•-g11t'".,,�1n'"'P""11""1.,.1 --=1a..,...,i"'"t;' Fir&�;l�PsYjno. N.!l�lrl1.:J>m���m :E CHF OMii CAD AORTIC GRAFT ARRHYTHMIA I .THE CAUSE OF DEATH? � 1• 19. 010 TOBACCO USf 30. IF

fl!lolALE IAooc! 10.$<): 0 Yeo li',l No 0 Y" 0 No

,9! COITTRIOUTE.10 OfATii1 0 Not pr•Oft•t11·1M0·�11 put year 0 Not pregnant, but pregnant 43 days 31. MANNER OF 0£ATH !i 0 Yes 0 Probably 0 Pregnan t at time or death to 1 year before death

!&I Natural D Homicide

15: O

j c;:iNo 0 Unknown D Not pregnant, but pregnant O Unknown if pregnant 'Mthln lhe past 0 Accident 0 Pending l_nvestlgalion within 42 a..v• of death yeec 0 Suicid1 0 Could not be detormifled

;_; 32. DATE OF INJURY (Mo/QayNr) W (Spell month) 33. TIME OF INJURY (2.ihr)I ����;:;0���r����.���::�·�)h1UM, lilml. •bot. conttNclron Mte. 35. INJURY AT WORK?

I 0Yes ONo U::I 'i!il!l:ii�·E �4'.�0C� A=�=o�N�C�F�IN�J�U�R=v .-.----�-------�- --------------------��------ 1

• """ State __________ City/Town or County ----------- ,Zip Code ___ _

IF DEATH WAS DUE TO OTHER

TliAN NATURAL

CAUSES,

THECOltONER

M!:!II COMPL..UE AND

SIONTHE

CER1111CATE

W Strnl and Number or Location Apertment Number

U ·==-=====�.,,,,..,=:,-':'=c=?.�;=:�=='��;;=:=�='=='=�=='��=='==����,...:.._-.,.�,---,-:�===-c� I )7. ���g���� ��iuig��:N,� ·u�i�?:r�."�JURY, STA7E THE TYP�s1s 1 OF VEHICLf(S) lNVOLveO(Au1omcl>llo. pickup, motorcycle, ATV, tfc'l d•. 11<, I

TRAl4S?ORTAT10Ntl l9o. WAS OECEOEll'T! 0 O<O'l•lOporolar 0 l'1•Mr19or b, Wl\o\T SAFETY O!VIC�S{5) CID OECECEJ;T USeJEMPLC'r? �J!)AV CNL'Y (J ""doofllon 0 °"'" (Sf>Oclfy)

139•, CERTIFIER (Cl'ltc:k My one, bu-.d on official c:tiPI� r� lhit c�tt•l

QSeatbalt 0 Cl'ild eafety seat O Helmet

(g1 PHYSICIAN 0 PHYSICIAN ASSISTANT 0 ADVA�CED PRACTICE PROFESSIONAL NURSE ·To the beat or my kt'IO'Medge, dulh occurred 111 the time, d�e. and place, and due lo !he� cause{a)/menner staled,

0 CORONER -On the rH•iJ or 1x1tn1u.\lon 1ndlor lrrv•t5ollici"- l'I my OCM"rlon. d9.th OCC1..11t•d at ch• 11:1�. dn•. � r;>l•r.e, •nd Cu.. to th..ft c:aVH[•)

HG"llnnt11tatea, Slgnotu11 and Tille of Cetllller � WAYNE RUB MD r 39d. NAME, ADDRE:.SS, AN� ZJP CODE OF CERTIFIER (Type or pnni•

WAYNE RUBY, 62J SOUTH MAIN STREET MOSCOW, ID 8J84J

'401. REGJSTRAR'.S .SIGN'ATUR!!:

This is a true and correct reproduction of. Lhe document officially registered and placed on file with the IDAHO BUREAU OF VITAL RECORDS AND/HEALTH STATISTICS.

0 Air bag D None O Unknown 39b. LICENSE NUMBER

M-04929

39c, DATE SIGNED _9_1 _jj_/.lQ1L_

MM DD YYVV

4Cb, DA TE �GN ED __lLl_.11._1..2ll12-.._

MM DO YYYY

/�!Ji� STA TE 'REGISTRAR