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Emerson Road - Drainage Easement -Roberts, DeborahCross Reference: Inst. #200300121453 2015025123 EASE $21.00 05/27/2015 12:04:02PM 5 PGS Jennifer Hayden Hamilton County Recorder IN Recorded as Presented 1111111 1 111111111111111111111111 I I I I I I I I 1 1111111111111111111111111111 DRAINAGE EASEMENT AGREEMENT c� .���•° KNOW ALL MEN BY THESE PRESENTS that the undersigned, Deborah L. Roberts, as tiles fee simple owners of certain real estate, (hereinafter collectively referred to as "Grantor "), for and in consideration of the sum of ____$1,725 . Dollar and no cent, in hand paid, the receipt and sufficiency of which is hereby acknowledged and confessed, does hereby GRANT, BARGAIN, SELL AND CONVEY UNTO The City of Carmel, Indiana, an Indiana municipal corporation, its successors and assigns (hereinafter referred to as "GRANTEE "), a perpetual drainage easement upon, over, under and across the real estate located in Hamilton County, Indiana, and described and depicted in Exhibit "A ", of which is attached hereto and hereby made part hereof, for the purpose of laying, installing, constructing, maintaining, operating, inspecting, altering, replacing and removing the drainage facilities. Grantee shall have the right of ingress and egress over, under, upon and across any land, driveways and roadways located on the surface of the lands owned by Grantors, their successors and assigns, upon and within the boundaries of the easement area, for purposes of access to the easement area. Said easement also includes the rights and privileges to temporarily use, from time to time, additional space, where available and necessary, that is adjacent to the easement area for equipment and materials necessary for the installation, repair and maintenance of Grantee's facilities located in, under, upon, over, and/or across the easement area, to do all acts and things requisite and necessary for the full enjoyment of the easement hereby granted, provided Grantee, their successors, agents, or employees restore the portion of the Grantors' property disturbed by their work to a condition that is as near the condition that existed just prior to the time the portion was disturbed by them as is practicable. Grantee also shall have the right from time to time to remove all trees, undergrowth, structures and/or other obstructions above, within, under, or immediately surrounding the easement area which may injure, endanger or interfere with Grantee's use and enjoyment of this easement, all of which work shall be done at Grantee's sole cost and expense, except as otherwise set forth herein. Grantors, their successors or assigns, shall not erect or maintain any permanent EXEMPT FROM SALES DISCLOSURES PE Cross Reference: Inst. #200300121453 DRAINAGE EASEMENT AGREEMENT KNOW ALL MEN BY THESE PRESENTS that the undersigned, Deborah L. Roberts, as the ¢D fee simple owners of certain real estate, (hereinafter collectively referred to as "Grantor "), for and in consideration of the sum of $1,725 Dollar and no cent, in hand paid, the receipt and sufficiency of which is hereby acknowledged and confessed, does hereby GRANT, BARGAIN, SELL AND CONVEY UNTO The City of Carmel, Indiana, an Indiana municipal corporation, its successors and assigns (hereinafter referred to as "GRANTEE "), a perpetual drainage easement upon, over, under and across the real estate located in Hamilton County, Indiana, and described and depicted in Exhibit "A ", of which is attached hereto and hereby made part hereof, for the purpose of laying, installing, constructing, maintaining, operating, inspecting, altering, replacing and removing the drainage facilities. Grantee shall have the right of ingress and egress over, under, upon and across any land, driveways and roadways located on the surface of the lands owned by Grantors, their successors and assigns, upon and within the boundaries of the easement area, for purposes of access to the easement area. Said easement also includes the rights and privileges to temporarily use, from time to time, additional space, where available and necessary, that is adjacent to the easement area for equipment and materials necessary for the installation, repair and maintenance of Grantee's facilities located in, under, upon, over, and /or across the easement area, to do all acts and things requisite and necessary for the full enjoyment of the easement hereby granted, provided Grantee, their successors, agents, or employees restore the portion of the Grantors' property disturbed by their work to a condition that is as near the condition that existed just prior to the time the portion was disturbed by them as is practicable. Grantee also shall have the right from time to time to remove all trees, undergrowth, structures and /or other obstructions above, within, under, or immediately surrounding the easement area which may injure, endanger or interfere with Grantee's use and enjoyment of this easement. all of which work shall be done at Grantee's sole cost and expense, except as otherwise set forth herein. Grantors, their successors or assigns, shall not erect or maintain any permanent structures, obstructions, or other improvements under and /or upon the surface of or over the easement area or perform any act which would impair or interfere with Grantee's use and enjoyment of the easement herein granted. TO HAVE AND TO HOLD unto Grantee, its successors and assigns, so long as the rights and easements herein granted shall be used by Grantee upon the terms and conditions specified herein, with ingress to and egress from the easement area, for the purposes of constructing, installing, repairing, maintaining, replacing and removing the facilities of Grantee herein described, but subject to all liens, encumbrances, restrictions and prior easements of record. It is agreed that this grant covers all the agreements between the parties and no representations or statements, verbal or written, have been made modifying, adding to or changing the terms of this agreement. The Grantors represent and certify that they are the fee simple owners of the easement area and real estate surrounding the easement area; that Grantors guarantee the quiet possession of the easement area to the Grantee; that the easement area is free of any liens or encumbrances, except the lien of current taxes and any other lien or encumbrance that, as of the date of execution hereof, appears of public record; and that, subject to the foregoing, Grantors will warrant and defend Grantee's title to the easement granted hereby against all claims thereon. The person or persons executing this instrument on behalf of Grantors hereby represent that they have the authority to bind Grantors, jointly and individually, to the terms and conditions set forth herein. This instrument may be executed by Grantors in separate counterparts, each of which shall constitute a duplicate original. IN TESTIMONY WHEREOF, Grantors herein have executed this conveyance Individually this, the 1 day of /1441/ //' toiert O.� STATE OF INDIANA ) SS: COUNTY OF HAMILTON , 2015. Before me, a Notary Public in and for said County and State personally appeared Deborah L. Roberts known to me to be the individual whose name is subscribed to the foregoing instrument and consideration therein expressed, and in the capacity therein stated. Given under my hand and seal of office, this / Sr— day of /r v , 2015. ary Public Notary Public Seal State of Indian Lance Stahley a Marton Count . s°,= • Y 6 is n Expires De ri 201 Commission Expiration: /1/Z0/ County County of Residence: /141g/OA/ cier ignature r CITY OF CARMEL, INDIANA BY ITS BOARD OF PUBLIC WORKS AND SAFETY Ames Brainard, Presi i�ng Of tc r Date: Maly Ann Buy e, Member Date: Lori Watso Date: ATTEST: ember Sandra M ioi -wsa>J Deputy a14 -u STATE OF INDIANA COUNTY OF SS: Before e, a Notary Public in and for said County and State, personally appeared James Brainard Mary Ann Burke, and Lori Watson by me known to be the Members of the City of Scu\aro SJ ohron , De lat Carmel Board of Public Works and Safety, and , Clerk- Treasure of the City of Carmel, who acknowledged the execution of the foregoing "Easement Agreement" on behalf of the City of Carmel, Indiana. Witness my hand and Notarial Seal this `' day of My Commission Expires: 2015. CLu.c, NOTARY PUBLIC Printed Name /L My County of Residence: r/71'/7? /.CjU,f) Date: /Zi,/•S" This instrument was prepared by Douglas C. Haney, Esquire, City Attorney, One Civic Square, Carmel, Indiana 46032. 1 affirm, under the penalties for perjury, that I have taken reasonable care to redact each Social Security Number in this document, unless required by law. ����� _, { et/ COUNTY: HAMILTON SECTION: 25 TOWNSHIP: 18 NORTH RANGE: 3 EAST " HATCHED AREA IS THE APPROXIMATE EASEMENT EXHIBIT 'A" EASEMENT EXHIBIT OWNER: DEBORAH L. ROBERTS EASEMENT DESCRIPTION DRAWN BY : CJL 01 -21 -15 CHECKED BY : GWC 20' 0 20' SCALE: 1' TEN FEET BY PARALLEL LINES OFF OF THE ENTIRE NORTHEASTERLY SIDE OF LOT 29 IN JOHNSON ADDITION RECORDED IN PLAT BOOK 2, PAGE 26 IN THE HAMILTON COUNTY RECORDER'S OFFICE. CONTAINING 0.020 ACRES, MORE OR LESS. " CO DEBORAH L. ROBERTS INST. #200300121453 LOT 29 JOHNSON ADDITION P.B. 2 PG. 26 I, GEORGE W. CHARLES II, A REGISTERED LAND SURVEYOR IN THE STATE OF INDIANA, DO HEREBY CERTIFY THAT THIS PLOT IS BASED ON THE PLAT OF JOHNSON ADDITION RECORDED IN PLAT BOOK 2, PAGE 26 IN THE HAMILTON COUNTY RECORDER'S OFFICE. NO FIELDWORK WAS PERFORMED AND THEREFORE, THIS DESCRIPTION IS SUBJECT TO ANY OVERLAPS, GAPS OR INCONSISTENCIES THAT A FIELD SURVEY MIGHT REVEAL. 5' UTILITY STRIP GEORGE W. CHARLES II gwcharles @crossroadengineers.com INDIANA LAND SURVEYOR NO. LS 20800117 25' N NORTH PREPARED BY: Transportation & Development Consultants 3417 9ERWY Ul Mai W.f. 01 46107 1317) 733-1536 Form W"9 (Rev. October 2007) Department of the Treasury Internal Revenue Service Request for Taxpayer Identification Number and Certification Give form to the requester. Do not send to the IRS. Print or type S Specific Instructions on page 2. Name (as shown on your income tax retum) 14e10 orc -h ,. - Rabe-) Business name, if different from above Check appropriate box: 1 IndividuaVSole proprietor 1 Corporation 1 Partnership • Limited liability company. Enter the tax classification (D= disregarded entity, C= corporation, P= partnership) ■ • Other (see instructions) ■ Exempt • Exem Address (number, and apt. or suite n•.) Requester's name and address (optional) :- /7S'ty, state, and ZIP code l �i+ *&7 .5 071 List account number(s) Are (opt •nal) Part Taxpayer Identification Number (TIN) Enter your TIN in the appropriate box. The TIN provided must match the name given on Line 1 to avoid backup withholding. For individuals, this is your social security number (SSN). However, for a resident alien, sole proprietor, or disregarded entity, see the Part I instructions on page 3. For other entities, it is your employer identification number (EIN). If you do not have a number, see How to get — - Note. If the account is in more than one name, see the chart on page 4 for guidelines c number to enter. Mao Certification Under penalties of perjury, I certify that: 1. The number shown on this form is my correct taxpayer identification number (or I ar 2. I am not subject to backup withholding because: (a) I am exempt from backup with Revenue Service (IRS) that I am subject to backup withholding as a result of a failun notified me that I am no longer subject to backup withholding, and 3. I am a U.S. citizen or other U.S. person (defined below). Certification instructions. You must cross out item 2 above if you have been notified b withholding because you have failed to report all interest and dividends on your tax retui For mortgage interest paid, acquisition or abandonment of secured property, cancellatioi arrangement (IRA), and generally, p. ments other than interest and dividends, you are not required to sign the Certification, but you must provide your correct TIN. See the ' ructions on page 4 Social security number , 6a4s 4245 -p zb o 6e r4 5 0- 311.709 •6o49 Sign Here Signature of U.S. person • 4 , 4,PP General Instructions Section references are to the Internal Revenue Code unless otherwise noted. Purpose of Form A person who is required to file an information return with the IRS must obtain your correct taxpayer identification number (TIN) to report, for example, income paid to you, real estate transactions, mortgage interest you paid, acquisition or abandonment of secured property, cancellation of debt, or contributions you made to an IRA. Use Form W -9 only if you are a U.S. person (including a resident alien), to provide your correct TIN to the person requesting it (the requester) and, when applicable, to: 1. Certify that the TIN you are giving is correct (or you are waiting for a number to be issued), 2. Certify that you are not subject to backup withholding, or 3. Claim exemption from backup withholding if you are a U.S. exempt payee. If applicable, you are also certifying that as a U.S. person, your allocable share of any partnership income from a U.S. trade or business is not subject to the withholding tax on foreign partners' share of effectively connected income. Note. If a requester gives you a form other than Form W -9 to request your TIN, you must use the requester's form if it is substantially similar to this Form W -9. Date • �f Q 1 do/5- Definition of a U.S. person. For federal tax purposes, you are considered a U.S. person if you are: • An individual who is a U.S. citizen or U.S. resident alien, • A partnership, corporation, company, or association created or organized in the United States or under the laws of the United States, • An estate (other than a foreign estate), or • A domestic trust (as defined in Regulations section 301.7701 -7). Special rules for partnerships. Partnerships that conduct a trade or business in the United States are generally required to pay a withholding tax on any foreign partners' share of income from such business. Further, in certain cases where a Form W -9 has not been received, a partnership is required to presume that a partner is a foreign person, and pay the withholding tax. Therefore, if you are a U.S. person that is a partner in a partnership conducting a trade or business in the United States, provide Form W -9 to the partnership to establish your U.S. status and avoid withholding on your share of partnership income. The person who gives Form W -9 to the partnership for purposes of establishing its U.S. status and avoiding withholding on its allocable share of net income from the partnership conducting a trade or business in the United States is in the following cases: • The U.S. owner of a disregarded entity and not the entity, Cat. No. 10231X Form W -9 (Rev. 10 -2007) LETTER OF TRANSMITTAL Date: May 11, 2015 To: Doug Haney Department of Law From: Jeremy Kashman SA' Department of Engineering RE: Little Cool Creek — Emerson Drive Drainage Project Doug, please see the attached parcel easement agreement, W -9, and easement exhibit for Deborah L. Roberts to be approved at the May 20th BPW meeting. Thank you.