HomeMy WebLinkAboutWaiver of Liability - PLN General GARY YANDO, DIRECTOR
PypN STA TFO
A O 7 DEPARTMENT Or COMMUNITY DEVELOPMENT
U
0 r z PLANNING - SOLID WASTE - UTILMES
7 N y � BLDG. I • 411 N. 5"' ST. • P.O. BOX 578
00 �� SHELTON, WA 98584 • (360) 427-9670
1864
DISCLAD1ER/\VAIVER OF COU n' LIABILITI': PE1334ITS ON L'>GSTWG LEGAL LOIS OF RECORD,
LAND DIViS10N APPROVALS. SCIORELINE PERT'QTS, VARIANCES, AND SPECIAL tlSf: PERNITTS:
11r_tc>icnignod properly 0, ez is .n erc of the unecriainty rcr.a:dutg Mason County's developmu-. :crulnnons crawl
61 0:c (irou'(h Mana-guncN liettnr-s Bci=rd's Order of Sep•ember 6, 1996. and in consider R:m:'. of i111 P.s On Cnunty's
wJ1:r._,:r_ts to proceed e-nli me czsu:_; of eophcniioa which :::,gl:: be Affected bl' that Order, the r..-.iersirnal pi olx.ny
o"ne. Ir.rebl agrees to "Rrvc an) i—sull. e.uion, or claim fit: d.m.nrgcz ngAn:st 1.1son County x',.. -h mne .rise out of
M eAcn Ca.rm y's aciioru in ecupxncc piocessmg and/or issu=:Icc of Snell pennns or eppro"Als (I::::iueftcr 'lict-nitting
aurora 1. "'Inch dsmagcs are eiinb.a=, , to inc Coun:) 's decision to take lrrunuwg actions despite ii,c ash thnt cluutges
to the Coun(y's developmeol regula:ons nughi later make the Coumy's rr_mwtutg actions invalid
) Q::W a�31 -2a - gooti a
Data r (Parcel No. or Legal Descrip.ioo)
Property owner's signature(Notarized)
(or the County may accept the signature of the owner's authorized agent upon proper proof authorization)
ACKNOWLEDGEMENT CER=CATE WED
STATE OF
COUNTY OF
On this _day of e _, bef a me Notary Public,
personally appeared personally known to me to be the person whose name is
subscribed to this instrument, a wl god t he/she ezocutod it.
WITNESS my hand and official seal.
- For Cowsry ease only
Reviewed by appticaru on
Q�
ate)
Notary's signature $ln1T Inilial�
My Conunission E:pires.