HomeMy WebLinkAboutWaiver of Liability - PLN General STgr GARY YANDO,DIRECTOR
PyON. �o
s° DEPARTMENT' OF COMMUNITY DEVELOPMENT
U
N Y PLANNING -SOLID WASTE - UTILITIES
of o~ BLDG. I • 411 N. 5TM ST. • P.O. BOX 578
1864 SHELTON, WA 98584 • (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 Hearin '
g Hearings Board's Order of September 6 1996 pt , 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.
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
Notary's signature
(Date)
My Comrnission Expires: Staff Initial: