HomeMy WebLinkAboutStatement of Fact - PLN General - 6/28/1996 STATEMENT OF FACT
WE, ALBERT P. DROUILLARD/FLORENCE K. DROILLARD, CERTIFY THAT THE
NEW BUILDING BEING ADDED TO THE PARCEL HEREIN DESCRIBED AND HAVING
MASON COUNTY ASSESSOR' S PARCEL NUMBER 12320-10-03300 IS INTENDED
FOR FAMILY USE AND IS NOT GOING TO BE USED AS A RENTAL UNIT.
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ON THIS DAY PERSONALLY APPEARED BEFORE ME QL�4 fi r bUW
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TO ME KNOWN TO BE THE INDIVIDUAL DESCRIBED IN AND WHO EXECUTED
THE WITHIN AND FOREGOING INSTRUMENT, AND ACKNOWLEDGED THAT
LQ� SIGNED THE SAME AS Q
FREE AND VOLUNTARY ACT AND DEED,
FOR THE USES AND PURPOSED THEREIN MENTIONED.
GIVEN UNDER THE HAND AND OFFICIAL SEAL DAY OF ,
1996 .
NOTARY PUBLIC -��
EXPIRATION DATE: �'�'� O /Qh
COUNTY RESIDING IN %Z; NOTARy'�•. :
PUBLIC �-