SPACE ABOVE THIS LINE FOR COUNTY RECORDER’S USE
COVENANT AND AGREEMENT
MAINTENANCE OF UNCERTIFIED FILL
(Pre-printed text shall not be changed except when done by an authorized Building and Safety Bureau employee.)
The undersigned hereby certify that (I am) (we are) the owner(s) of real property located in the City of Long Beach, State
of California that is hereinafter legally described (as follows) (on the attached exhibit(s) __________________________):
LEGAL DESCRIPTION:
LOT____________BLOCK_____________ TRACT______________________________________________________
LOT____________BLOCK_____________ TRACT______________________________________________________
LOT____________BLOCK_____________ TRACT______________________________________________________
as recorded in BOOK___________________PAGE___________________, Records of Los Angeles County.
This property is located and known as the following ADDRESS: _____________________________________________
This covenant and agreement is executed as a condition of approval from Long Beach Development Services, City of
Long Beach, State of California. I am (We are) fully aware that an existing pool or spa shell was left in-place and backfilled
with uncertified fill on this site (SEE ATTACHED PLOT PLAN FOR LOCATION). Furthermore, I am (we are) fully aware
that uncertified fills are not to be used to support buildings or structures. As a condition of the approval granted by the City
of Long Beach, I (we) agree to use this area only for open space and not for any structural support.
This covenant and agreement shall run with all of the above described land and shall be binding upon ourselves, and
future owners, encumbrances, their successors, heirs or assignees and shall continue in effect until released by the
authority of the Building Official of the City of Long Beach upon submittal of request, applicable fees and evidence that
this covenant and agreement is no longer required by law.
