HomeMy WebLinkAboutWaiver of Liability - PLN General - 9/5/1997 GARY YANDO,DIRECTOR
y�N.STA
s
O �, DEPARTMENT OF COMMUNITY DEVELOPMENT
O T 2 PLANNING -SOLID WASTE- UTILITIES
N Y BLDG. I • 411 N. 5TH ST. • P.O. BOX 578
1864 SHELTON,WA 98584 • (360)427-9670
DISCLAPgER/WAIVER OF COUNTY LIABILITY: PERMITS ON EXISTING LEGAL LOTS OF RECORD,
LAND DIVISION APPROVALS, SHORELINE PERMITS, VARIANCES,AND SPECIAL USE PERNHTS:
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.
32Z32 Z
Date (Parcel No. or Legal Description)
Property owner's signature(Notarized) P,� MVEQ
(or the County may accept the signature of the owner's authorized age pap Wof orization)
NOTARY
�0 PUBLIC a
ACKNOWLEDGEMENT CERTIFICATE (INDIVIDUAL) 'r�T 'C>�BER Q' �/`o
F STATE OF OF
�niiw�+»wa"�r•
COUNTY OF �,(,(/��IjbI — -
On this a day of_��, in the year L qL before me 7�(J)`Q S Notary Public,
personally appeared E-A w aIGA /!1 ��QZ NFJZyknown tome 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
J (Date)
N 's signature ^„
Staff Initial:
My Commission Expires:
HiCy�l�.ai
GARY YANDO,DIRECTOR
P�oN.S r-A
MO DEPARTMENT OF COMMUNITY DEVELOPMENT
AU _
O T = PLANNING - SOLID WASTE - UTILITIES
N Y Y BLDG. I • 411 N. 5'N ST. • P.O. BOX 578
OJ �� SHELTON, WA 98584 • (360) 427-9670
rssa .
DISCLAMIER/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 attnbutable 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.
Gt, �� q `3aa-�Q�� q c-) i i --)-
Date (Parcel No. or Legal Description)
Property owneW 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: