HomeMy WebLinkAboutNOTICE TO FUTURE PROPERTY OWNERS OF PRIVATE TWO PARTY WATER SYSTEM - OTH Recorded Documents - 1/22/2021 2148768 MASON CO WA
01/22/2021 11 37 AM NOTCE
Name and Return Addre s: BRRBORA WILDERBUER ti151401 Roc Fee: $104.50 Pages 2
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Reference Numbers(s)of Documents Assigned or Released
ADDITIONAL REFERENCE II'S ON PAGE
Grantor(s)
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2. ADDITIONAL GRANTORS ON PAGE
Grantee(s)
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2. ADDITIONAL GRANTEES ON PAGE
Legal Description (abbreviated form:i.e.lot,block,plat or section,township,range,quarter/quarter)
ADDITIONAL LEGAL IS ON PAGE
Asseslor's Property Tax Parcel/Account Number(s).O 12 — Z,.3 -- ``1 D D 8 cZ
--8O 1 2 — 2. — ci Oa g D ADDITIONAL PARCEL#'S ON PAGE
THE AUDITOR/RECORDER WILL RELY ON THE INFORMATION PROVIDED ON THIS FORM.THE STAFF WILL NOT READ THE
DOCUMENT TO VERIFY THE ACCURACY OR COMPLETENESS OF THE INDEXING INFORMATION PROVIDED HEREIN.
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NOTICE TO FUTURE PROPERTY OWNERS OF PRIVATE TWO-PARTY WATER SYSTEM
I (We)the undersigned, certify that the water source located on parcel situated in Mason County,State of
Washington,herein described. o -Z — .�3 r !a p Q A) 0
OR
Subdivision Division Lot Range Township Section
And having the Tax Parcel Number of: -- --
Has been designated to serve a source of water to the following parcels situated in Mason County, State of
Washington; herein described: (abbreviated legal description and tax parcel numbers(s)of property(ies)affected )
OR � ) `�- r �3 -- 9 v o c(�
Subdivision Division Lot Range Township Section
And having the Tax Parcel Number of: -- --
OR
Subdivision Division Lot Range Township Section
And having the Tax Parcel Number of: -- --
The system owner is responsible for kee ing this system in compliance. JJ
The name of the system is t' V i l a e r PU-e-t' t'V a �
This system is designed to provide for two services. Planning and design approvals must be obtained
from the department prior to expanding beyond this number of services. Additionally, a water right,
obtained from the Department of Ecology, is required if the water system exceeds exemption standards.
T • ystem (has/has t) been granted one or more waivers from specific provisions of the
n
Signature Signature
tate of Washington
County of Mason
1y1Wersign d . a Notary Public in and for he above named con qnd State, do hereby certify that on this
ay of , 20 7.-f , • l .Yc hl l sonally appeared before
me,who is kno n to be signer of the above instrument, and acknowledged that he(she)(they)signed it.
GIVEN under my hand and official seal the daydt,0lMtpiliabove wr en.
*CEVE ?% 1C 1NT F $otary Public i for the to of shi ton
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•a ' N; 14 commission expires : �o�- 3-1
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