HomeMy WebLinkAboutWaiver of Liability - PLN General - 11/29/1997 GARY YANDO,DIRECTOR
yON.STArFO
A O v DEPARTMENT OF COMMUNITY DEVELOPMENT
o T i PLANNING -SOLID WASTE-UTILITIES
N V . BLDG. I • 411 N. 5TH ST. • P.O. BOX 578
of 1864 �o 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 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 noun j'f.de;'1Cj^iTi't^.t regi-Jelions night Ater make th•";County's permitting actions invalid.
2_ _ c� - Z TICZ,6 of svI-a•ey l/2la—;Z
Date (Parcel No. or Legal Description)
Pro wner'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 Leh)Y AQU
COUNTY OF _
On this J day of PC r , in the year ,pefore me i l'` C I�cCZ Y 1 Notary Public,
personally .appeared 0 Lie Lf C( .CC)Q SMj personally known to me to be the person whose name is
subscribed to this instrument, and acknowledged that he/she executed it. ti Rs Lcxk [)r
WITNESS my hand and official seal.
-For County use only-
Reviewed by applicant on
�— (Date)
Nota signature
Staff Initial:
My Commission Expires: 1 I -n j