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WAIVER OF LIABILITY AND HOLD HARMLESS AGREEMENT <br /> 1. In consideration for receiving permission to construct a storage shed within the drainage easement located at 2945 <br /> Scotland Parkway, Sun Prairie, WI 53590 (see attached Plat of Survey: Scottish Highlands, Lot 4), I hereby release, <br /> waive, discharge and covenant not to sue The Town of Bristol, Dane County WI, its officers, servants, agents and <br /> employees(hereinafter referred to as"releasees")from any and all liability,claims,demands,actions and causes of action <br /> whatsoever arising out of or relating to any loss, damage or injury that may be sustained by me, or to any property <br /> belonging to me as a result of construction in a drainage easement. <br /> 2. I further agree to confine fill above the current grade to the north side of the structure and agree that there will be <br /> no fill or obstruction of the existing drainage on the south and west sides of the structure. <br /> 3. It is my express intent that this Release shall bind the members of my family and spouse, if I am alive, and my <br /> heirs, assigns and personal representative, if I am deceased, and shall be deemed as a Release, Waiver, Discharge and <br /> Covenant Not to Sue the above named releasees. Further,this agreement will apply to future owners or assigned parties of <br /> 2945 Scotland Parkway, Sun Prairie WI 53590. <br /> 4. This agreement is solely for the construction of this storage shed and does not allow for any other construction <br /> activity in the drainage easement. <br /> In signing this release,I acknowledge and represent that: <br /> A. I have read the foregoing release,understand it,and sign it voluntarily as my own free act and deed; <br /> B. No oral representation,statements or inducements,apart from the foregoing written agreement,have been made; <br /> C. I am at least eighteen(18)years of age and fully competent;and <br /> D. I execute this Release for full,adequate and complete consideration fully intending to be bound by same. <br /> In witness whereof,I have hereunto set my hand and seal this lay of / "� 1al , �d�.1 <br /> Owner Signature: �' .zo <br /> Name Printed: /vnf (/ /14.-,,i. <br /> Witness: fd41-4- 0. 4--e <br /> Witness e Printed: 61M_ A. \I Q e-it <br /> ■ <br /> For the • of B%. <br /> A <br /> ' 3 - / - /‘ <br /> Gerald H.Derr,Bn of Town Chairman Date <br /> } <br /> Attest <br /> CI0L . <br /> (3/7A6/6 <br /> Klister,Bristol Town Clerk/Treasurer Date <br /> Z? 2 0 1-5 - 0 0V <br /> Oc � <br />