Fill and Sign the County State of Indiana Form

1 SEWER EASEMENT This document is exempt from Sales Disclosure Form requirement of P.L. 63-1993 § 2. This indenture witnesseth that: of County, State of Indiana (hereinafter called "Grantor") for and in consideration of the sum of $ and other good and valuable consideration, the receipt of which is hereby acknowledged, does hereby grant, sell and convey to , (hereinafter called "Grantee") a permanent, exclusive easement and right-of-way to place, construct, operate, control, maintain, reconstruct, relocate, change the size of, repair and remove sewer mains, pipes and conduits, all necessary or incidental auxiliary or feeder serv ice mains, pipes or conduits, lift stations, manholes and other facilities, appliances , apparatus and structures convenient or proper for the purpose of rendering sewage disposal services (the "Sewer Facilities") along, under, through and across the Grantor's real estate situ ated in County, State of Indiana, more particularly describe d on Exhibit(s) “A” attached hereto and made a part hereof ("Real Estate"). Access to the Real Estate over the adjoining lands of the Grantor, where necessary, is hereby granted to the Grantee; provided however, that wherever the Sewer Facilities are accessible from an adjoining public street or highway, the access shall be from such st reet or highway. Grantor shall have the right to fully use and enjoy the Real Estate except for such use as may impair, impede or unreasonably interfere with the exercise by Grantee of the rights granted herein. Grantor shall not construct or permit to be constructed any house, structure, or obstruction (other than ground cover or pavement for driveway or parking purposes) on or over the Sewer Facilities, or that would interfere with the construction, maintenance or operation of any part of the Sewer Facilities. Grantor shall not construc t or permit to be constructed: (i) any paved or concrete driveways, parking areas, sidewalks, patios, or similar structures over or within a one (1) foot horizontal distance of any sanitary sewer manhole castings existing on the Real Estate; (ii) any paved or concrete roads, streets or other thoroughfares over or within a five (5) foot horizontal distance of any sanitary sewer manhole castings existing on the Real Estate; or (iii) any light pole s, street lights, or outdoor lights of any kind directly over or within a ten (10) foot horizontal distance of any Sewer Facilities existing on the Real Estate. Grantor shall not place or allow to be placed the toe of a slope of earthen mounding within ten (10) feet horizontal distance of any Sewer Facilities existing on the Real Estate. Further, Grantor shall not plant, or allow to grow any trees, shrubbery or similar growths directly over or within ten (10) feet horizontal distance from the dripline of the planting to Sewer Facilities. Further, Grantor agrees not to change or permit the change of the grade of earth covering the Sewer Facilities. The Grantee may cut, trim, or remove any and all trees, shrubs, underbrush, bushes, saplings, ground cover, lawns, gardens, landscaping, irrigation systems or other similar vegetation, growth or structures, now or hereafter existing or growing upon or extending over the Real Estate, insofar as may be reasonably necessary utilizing due care, in t he exercise by the Grantee of any and all rights and authorities herein and hereby granted to 2 Grantee. The exercise of this right by the Grantee, or any other rights herein granted to Grantee, shall not establish in the Grantor any right or claim for damages to such trees, shrubs, underbrush, bushes, saplings, ground cover, lawns, gardens, landscaping, irrigation systems or other similar vegetation, growth or structures. Any damage to any private gravel or unpaved drives, drainage pipe or tile, or fences of the Grantor (but exclusive of trees, shrubs, underbrush, bushes, saplings, ground cover, lawns, gardens, landscaping, irrigation systems or other similar vegetation, growth or structures and exclusive of asphalt or concrete pavement for sidewalk, access path, driveway or parking purposes) caused by the construction, operation, maintenance or repair of the Sewer Facilities shall be repaired or replaced by the Grantee; provided, however, that wi th respect to damaged lawns Grantee agrees to provide initial reseeding of grass for such damaged areas. The easement rights and privileges granted herein are exclusive and the Grantor cove nants that it will not hereafter convey any other easement or conflicting right within t he area covered by this grant. To the extent the easement rights granted herein cross, inters ect, or coexist with an existing easement of record, the easement granted herein shall not be exclusive with respect to that portion of such prior existing easement with which the easement granted herein crosses, intersects, or coexists. Notwithstanding the excl usivity of the easement herein granted, all storm drainage facilities and utility pipes or c onduits for other utility services with five (5) feet minimum vertical clearance from t he Sewer Facilities may intersect the Sewer Easement granted herein at a ninety (90) de gree angle plus or minus fifteen (15) degrees at any point except at locations within twenty (20) linea r feet from a sanitary manhole structure, and all streets, roads or sidewalks may inte rsect the Sewer Easement granted herein at a ninety (90) degree angle plus or minus fifteen (15) degrees at any point except, as concerns sidewalks, at locations within one (1) linear foot from a sanitary manhole structure and, except as concerns streets or roads, at locations within five (5) linear feet from a sanitary manhole structure. Notwithstanding any other provisions of this Sewer Easement, Grantee shall have the absolute right at any time, and from time to time, to construct and install other main extensions or lateral main exte nsions and appurtenant facilities of any nature connecting to the Sewer Facilities. Sai d easement also includes the rights and privileges (1) of ingress and egress for the employees , agents and representatives of Grantee, its grantees, successors, and assigns, to, from, and ove r the Real Estate, (2) to use temporarily additional space where available and necessa ry from time to time adjacent to the Sewer Facilities for equipment and material s necessary for installation, repair and maintenance of Grantee’s facilities located in, under, upon a nd across the Real Estate, and (3) to do all acts and things requisite and necessary for the full enjoyment of the easement hereby granted. Grantor agrees that Grantee shall be enti tled to and Grantor shall provide any and all easements necessary to allow the construction of and to provide for access to the Sewer Facilities for the purpose of connecting such additional extensions and facilities to the Sewer Facilities. Grantee shall have full right and authority to assign or convey the easement hereby granted or any part thereof to another sewer utili ty or a successor in interest, but shall have no right to assign or convey the easement here by granted or any part thereof to another utility not engaged in providing sewer service. The 3 grants, covenants and stipulations herein provided shall extend to and be binding upon the respective heirs, successors and assigns of the parties. The undersigned executing this Sewer Easement on behalf of Grantor represent and certify that Grantor is the owner of the Real Estate, that the undersigned is duly authorized and fully empowered to execute and deliver this easement, that Grantor has full legal c apacity to convey the easement described herein, and that all necessary action for the making of such conveyance by Grantor has been taken and done. The prior deed reference required by I.C. § 32-23-2-5 for the Real Estate burdened by the easement herein granted is recorded in the office of the Recorder of County, Indiana, as Instrument No(s) . Executed this day of , 20 by "Grantor". Signature and Title Signature and Title Printed Name Printed Name STATE OF INDIANA ) ) SS: ) COUNTY OF Before me, a Notary Public in and for said County and State, personally appeared , the of , (the Company) who acknowledged the execution of the foregoing Sewer Easement, for and on behalf of the Company, and who, having been duly sworn, stated that any representations therein contained are true. Witness my hand and Notarial Seal this day of , 20 . Notary Public (Printed Name) Resident of County My Commission expires: This instrument prepared by , Esq., , , , Indiana . Return recorded instrument to 4 I 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. _______________________________ (Name of Preparer)