LLP Sewer Release Form

Instrument Prepared By: Raleigh City Attorney’s Office Brief Description for Index: ______Property I.D. Number: ______

Mail After Recording To: City of Raleigh Development Services Customer Service Center PO Box 590 Raleigh, NC 27602

RELEASE, CONSENT, AND NOTICE NON-STANDARD SANITARY SEWER INSTALLATION

THIS RELEASE, CONSENT, AND NOTICE is made and given this ____ day of ______, 20___, by ______, hereinafter referred to as the “Owners”, to the City of Raleigh, a North Carolina Municipal Corporation.

WITNESSETH:

WHEREAS, the Owners are the owners of property located at ______, having the legal description as follows: ______; and

WHEREAS, the Owners desire to install or have installed, at the building or buildings located at the above referenced address, weirs of traps from plumbing fixtures or drains which are lower than the elevation which is 1 foot above the top of a sewer main manhole located upstream from the building sewer connection serving the traps (the “plumbing installation” or “installation”); and

WHEREAS, pursuant to §10-6084 of the Raleigh City Code, such installation does not conform to the standards of the City of Raleigh and, accordingly, will not be allowed unless and until a Release, in recordable form, is executed and given to the City by the Owners; and WHEREAS, upon execution by the Owners and recordation of this instrument by the City, the Owners may make and use such plumbing installation, subject to terms and conditions set forth herein.

NOW, therefore, in consideration of the premises, the mutual benefits accruing hereunder to the City, the Owners, and the public, and for other good and valuable consideration, the Owners do hereby RELEASE AND DISCHARGE the City of Raleigh, it’s officers, employees, and agents, from any and all liability for claims, damages and causes of action which may result from sewage backflow from the Owners’ premises identified above.

IT IS FURTHER ACKNOWLEDGED AND AGREED by the City, upon acceptance and recordation of this instrument, that the plumbing installation may be installed and/or continued in use, as applicable, by the Owner, their heirs, successors and assigns, subject to terms and conditions hereof. Accordingly, for so long as the plumbing installation continues in service, these covenants shall run with the above-described property, and be binding upon the Owners’ heirs, successors and assigns.

APPLICATION AND RELEASE APPROVED:

BY: (INSPECTOR) ______(DATE) ______IN WITNESS WHEREOF, the Grantors have hereunto set their hands and seals, on the day and year first above written.

______PARTNERSHIP NAME A Limited Liability Partnership

BY: ______(SEAL) General Partner

APPROVED AS TO FORM:

______(Deputy) City Attorney

STATE OF ______COUNTY OF ______

I, ______, a Notary Public in and for the County and State aforesaid, certify that ______, general partner(s) of ______, personally appeared before me this day and acknowledged the execution, with proper authorization, of the foregoing instrument, all in accordance with a limited liability partnership instruments recorded in Book ______, Page ______, in the ______County Registry and that the instrument is the act and deed of the partnership. WITNESS my hand and notarial seal this the ______day of ______, ______.

______(Notary Seal) ______, Notary Public Notary’s printed or typed name

My Commission Expires: ______