HomeMy WebLinkAboutTitle Noitification Aquifer Area - PLN General - 1/31/1996 GARY YANDO,EXRECTOR
PSG%.sTA
o A o u DEPARTMENT OF COMMUNITY DEVELOPMENT
o T = PLANNING -SOLID WASTE- UTILITIES
z� N Y y BLDG. I • 411 N. 5TH ST. • P.O. BOX 578
of 1864 ao SHELTON,WA 98584 • (360) 427-9670
1996
Pat Birgen
228 San Joaquin Ave
Shelton, WA 98584
Re: Permit no. : BLD96-1457
Dear Mr Birgen:
Review of your permit application shows that your proposed
development lies within a highly critical aquifer recharge area as
defined and identified under Chapter 17. 01.080 of the Mason County
Interim Resource Ordinance.
In order to protect the public health and safety, prevent the
degradation of groundwater aquifers used for potable water, and to
provide for regulations that prevent and control risks to the
degradation of groundwater aquifers, Mason County has adopted
standards for development in those parts of the county which have
been identified as critical aquifer recharge areas.
Prior to permit approval it is a requirement that the legal owner
of the property execute a Title Notification of Aquifer Recharge
Area and record it with the Mason County Auditor's office. A blank
Title Notification form is enclosed for your use.
1. Complete the enclosed form, having the signature notarized.
2 . Record the document with Mason County Auditor's office; at the
same time, obtain a copy of the recorded document.
3 . Turn in the recorded COPY to the Planning Department for
retention in our files.
In the meantime your permit application will continue to be
reviewed by other departments . If you have any questions about
this process, please feel free to contact me at (360) 427-9670
extension 294 .
Sincerely,
Pam Bennett-Cumming
Land Use Planner
encl : Title Notification of Aquifer Recharge Area
GARY YANDO,DIRECTOR
y�N.STgTFo�
M U U �, DEPARTMENT OF COMMUNITY DEVELOPMENT
o T Z PLANNING -SOLID WASTE-UTILITIES
N Y y BLDG. I • 411 N. 5TH ST. • P.O. BOX 578
of 1864 ao SHELTON,WA 98584 a (360) 427-9670
DISCLAIMER/WAIVER OF COUNTY LIABILITY: PERMITS ON EXISTING LEGAL LOTS OF RECORD,
LAND DIVISION APPROVALS, SHORELINE PERMITS, VARIANCES,AND SPECIAL USE PERMITS:
The undersigned property owner is aware of the uncertainty regarding Mason County's development regulations created
by the Growth Management Hearings Board's Order of September 6, 1996, and in consideration of Mason County's
willingness to proceed with processing of applications which might be affected by that Order,the undersigned property
owner hereby agrees to waive any lawsuit, action, or claim for damages against Mason County which may arise out of
Mason County's actions in acceptance, processing and/or issuance of such permits or approvals (hereinafter"permitting
actions'),which damages are attributable to the County's decision to take permitting actions despite the risk that changes
to the County's development regulations might later make the County's permitting actions invalid.
D08 - �?- 20l,6-/
Date (Parcel No. or Legal Description)
Property owner's signature(Notarized)
(or the County may accept the signature of the owner's authorized agent upon proper proof of authorization)
ACKNOWLEDGEMENT CERTIFICATE (INDIVIDUAL)
STATE OF
COUNTY OF
On this day of , in the year ,before me Notary Public,
personally appeared personally known to me to be the person whose name is
subscribed to this instrument, and acknowledged that he/she executed it.
WITNESS my hand and official seal.
-For County use only-
Reviewed by applicant on
(Date)
Notary's signature Staff Initial:
My Commission Expires:
�- S �
r
TITLE NOTIFICATION OF AQUIFER RECHARGE AREA
DATE: /'/ s' / PARCEL NO.: -' 16/5/
LEGAL
DESCRIPTION: < �- S _ ����- a�5� �d ! ZI�IV 1211E /
OWNER: FAT 5 0 Fo
NOTICE: This site lies within an Aquifer Recharge Area as defined by Chapter
17.01, Mason County Code. The site was the subject of a development for:
List proposal(s), corresponding permit number(s), and application date(s):
APPLICATION
TYPE OF PROPOSAL PERMIT NUMBER DATE
Restrictions on use or alteration of the site may exist due to natural conditions of
the site and resulting regulation. Review of such application has provided
information on the location of an aquifer recharge area and the restriction-on their.
use. A copy of the plan showing the aquifer recharge area is attached hereto.
Signature of Ow '
On this day personally appeared before a ,.to me
known to be the individual described in and who executed the within and foregoing
instrument, and acknowledged that signed the
same as /, s , free and voluntary act and deed, for the
uses and purposes therein mentioned.
GIVEN under my hand and official seal this `�`�' day of 2,--, , , 1997 .
Notary Publici� T .�
-.Expiration Date: 4a-�9-c57a
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A U 0 1 T GR M AS ON cOUzjjy
RETURN ADDRESS ® � . a ALLh T. BROTCHL
1991 JAN 13 A 10: 5 3
REQU`ST OF:
Please print neatly or type information
Documeat Ti.tle(s 4X
7"�y Al i t
Reference Numbets(s) of related documents
Additional Reference 7"'s on page—
Grantor(S) (Last,First and Middle Initial)
s
Additional grantors on page_
Grantees) (Last,First and Middle Initial)
Additional grantees on page_
Legal Descnptlon (abbreviated form:i.e.lot,block,plat or section,township,range,quarter/quarter)
Additional legal is on page
Assessor's Property Tax Parcel/Account Number
,ZIA aag -7 -7 �7d1 -�/
Additional parcel I'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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