STATEMENT OF CONDITIONS FOR USE OF

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1 STATEMENT OF CONDITIONS FOR USE OF WATER FACILITY EASEMENT GRANTEE: PORTLAND WATER BUREAU of the CITY OF PORTLAND, a municipal corporation of the State of Oregon LEGAL DESCRIPTION: (Attached hereto) SITE NAME (IF APPLICABLE): SITE ADDRESS (IF APPLICABLE): TRUE AND ACTUAL CONSIDERATION: AFTER RECORDING RETURN TO: MAIL TAX STATEMENTS TO: The provision of water service to Grantor s property, and other good and valuable consideration. Portland Water Bureau of the City of Portland Survey/ROW Services 1120 S.W. Fifth Avenue Portland, OR Not Applicable (No Change) SPACE BELOW THIS LINE FOR USE OF COUNTY RECORDER S OFFICE STATEMENT OF CONDITIONS FOR USE OF 1

2 WATER FACILITY EASEMENT GRANTED TO PORTLAND WATER BUREAU, of the CITY OF PORTLAND, OREGON All public utility easements created in the plat of (or, in the land partition, PUD, or privately-owned street, described more particularly in Exhibit A, attached hereto) are subject to the following terms and conditions: 1. In consideration of the provision of water service to Grantor s property, and other good and valuable consideration, Grantor conveys to Grantee the perpetual easement rights described herein, for the purpose of constructing, reconstructing, inspecting, maintaining and/or operating public water system facilities and necessary appurtenances, which are located within the Grantor's property described herein. Grantee may construct and/or assume ownership of only such permanent or temporary surface or underground structures within the easement as are required for its water lines, facilities and appurtenances and their inspection and maintenance. Grantee s agents or employees may enter on the Grantor's property within the easement area only for the purpose of constructing, reconstructing, inspecting and maintaining its facilities, lines and appurtenances. 2. No permanent or temporary surface or underground structure or facility, including public or private utility line(s), (except Bureau of Environmental Services facilities that conform to the requirements of OAR 333) or other improvements, shall be constructed or located within the easement without the prior written consent of the Chief Engineer of the Grantee, which consent shall not be unreasonably withheld. All construction activities and structures must comply with federal, state, and local law. 3. The easement area shall be kept open, accessible, and passable at all times with the exception that obstructions to accessibility shall be approved in writing by the Chief Engineer of the Grantee prior to their installation or construction. 4. In the case of a Water Facility Easement within a private development, "Planned Unit Development ( PUD ), non-public roadway, or similar configuration, if agreement on all terms and conditions of this easement (particularly accessibility) cannot be reached between Grantor and Grantee, the Grantee may require master metering of all affected water services from an adjacent water main in public right-of-way. All costs associated with a change of the water system and facilities to a master metered system shall be borne by the Grantor. 5. No grade change in excess of one (1) foot in elevation shall be allowed within the easement without the prior written consent of the Chief Engineer of the Grantee, which consent shall not be unreasonably withheld. 6. No trees shall be planted within the easement without the prior written consent of the Chief Engineer of the Grantee. 7. Private water facilities shall not be connected to water facilities owned and/or controlled by the Grantee without appropriate permits from the Grantee. 8. No materials shall be stored, used, manufactured or disposed of within the Water Facility Easement, except in compliance with all federal, state, and local law, provided that in no case may there be stored, used, manufactured, or disposed of within the easement, any hazardous substances, or any substances or materials which constitute a public health hazard, as defined by rules of the Oregon State Health Division. No condition shall be permitted within the easement which constitutes a health hazard, as defined by rules of the Health Division. As used in this Easement, Hazardous Substance means: (i) any hazardous substance as defined by the Comprehensive 2

3 Environmental Response, Compensation and Liability Act, as amended from time to time; or (ii) any hazardous waste defined by the Resource Conservation and Recovery Act of 1976, as amended from time to time; or (iii) any hazardous substances as defined by Oregon Revised Statute and/or implementing regulations of the Oregon Department of Environmental Quality; or (iv) any and all material or substance defined as hazardous pursuant to any federal, state or local laws or regulations or order; or (v) any and all material or substance which is or becomes regulated by any federal, state or local governmental authority; or (vi) any and all material or substance which contains oil, gasoline, diesel fuel or other petroleum hydrocarbons and their by-products. 9. The Grantee shall within a reasonable time after completion of construction or maintenance work restore the surface condition of the easement to a state equal to or better than its state prior to the construction or maintenance. The Grantee agrees to use vegetation equal to or better than that existing prior to construction or maintenance in the restoration of any landscaping of the easement. The Grantor agrees to maintain the surface of the easement after completion of the restoration work performed by the Grantee. 10. The terms and conditions of this Water Facility Easement shall be binding on all current and future owners of the parcel(s) encompassing the easement. All new owners and/or contract purchasers shall be provided a copy of this easement by Grantor, at the time of transfer of title or interest by Grantor. The Grantor shall construct any private street within which this easement is located according to the City of Portland s applicable Guidelines and Standards for private residential streets. When so requested by the City of Portland, the property owner(s) adjoining the private street shall enter into a Maintenance Agreement acceptable to the City of Portland, that specifies the standards of maintenance for the street. 11. The Grantor shall hold Grantee, its officers, employees, and agents, harmless from any expense, loss, or liability, including legal fees, arising from claims for property damage or personal injury or death not caused by the Grantee's facilities or Grantee s activities in constructing, reconstructing, maintaining, or repairing its facilities, including from any liability imposed by law for the clean-up or damages caused by the release or disposal of hazardous substances within the easement, except for release or disposal of hazardous substances caused by Grantee, its officers, employees or agents. 12. Twenty-four hours prior to the commencement of work within the easement that may affect access, security or have a detrimental impact upon the properties accessed by the private street, the Grantee shall notify the affected parties of the intended work, orally or in writing. All reasonable efforts will be made to minimize any impacts. In the event the Grantee must undertake emergency work, such notice shall be provided either before or after commencement of the work, as the emergency reasonably allows. 13. Seventy-two hours prior to the commencement of any construction work within the easement that will (or has the potential to) affect the public water system, the Grantor shall notify the Grantee in writing or orally, and describe the nature and extent of the intended work. 14. This Statement of Conditions document will be recorded with the applicable County Recorder s Office. This document will be referenced on the Grantor s subdivision plat, partition, PUD or other applicable map at the time of recording the plat or map. The following statement shall appear on the final recorded plat or map: Statement of Conditions for Use of Water Facility Easement recorded in (name of County) County Records on (date recorded) as Document No: (Recorder s document No.). IN WITNESS WHEREOF, the parties have caused this instrument to be executed on the date(s) shown hereinafter; and mutually agree this instrument to be in full force and effect upon the date it has been executed by both Grantor and Grantee as provided for herein. Name: Name: 3

4 Title: Title: STATE OF ) ) ss COUNTY OF ) On this day of, before me personally appeared, and, whose identity is (are) personally known to me (or proved to me on the basis of satisfactory evidence) to be the person(s) whose name(s) is (are) subscribed to this instrument, and acknowledged that (he) (she) (they) executed the same. If this instrument is executed by a corporation, the person(s) executing this instrument acknowledged that this instrument was executed by (him) (her) (them) on behalf of and by authority of said Corporation, and acknowledged said Corporation executed the same. Notary Public for: My Commission Expires: 4

5 GRANTEE: PORTLAND WATER BUREAU OF THE CITY OF PORTLAND, a municipal corporation of the State of Oregon By: Name: Michael L. Stuhr Title: Chief Engineer STATE OF OREGON ) ) ss COUNTY OF MULTNOMAH ) On this day of, before me personally appeared Michael L. Stuhr, whose identity is personally known to me (or proved to me on the basis of satisfactory evidence) to be the person whose name is subscribed to this instrument, and acknowledged that he executed the same as Chief Engineer of, and on behalf of the Portland Water Bureau of the City of Portland, a municipal corporation of the State of Oregon, by and pursuant to authority granted to the Chief Engineer of said Bureau by Ordinance Numbers and , both approved December 9, 1998 by the City Council of the City of Portland, Oregon. NOTARY PUBLIC FOR OREGON My Commission Expires: STMNT.doc 5

CHAPTER 2 RELATED DOCUMENTS AND FORMS

CHAPTER 2 RELATED DOCUMENTS AND FORMS TABLE OF CONTENTS CHAPTER 2 RELATED DOCUMENTS AND FORMS Resolution R00- Establishing Public Improvement Design Standards Page 1 Current Plans Review & Construction