HomeMy WebLinkAboutRLC98-0051 - RLC Inspections - 3/19/1998 • RESOURCE LANDS & CRITICAL AREAS CHECKLIST
Date Received RLC# 9V
Owner Parcel Number
1 .Saltwater/Lake 20 >_ acres Designation
Name of Waterbody
O 2X Rivers, streams, or creeks
Type of Water
❑ 3. "akes or ponds less than 20 acres in size
4. Wetlands: Areas that are inundated or saturated by surface water that
under normal circumstances support vegetation adapted for life in such
conditions as the following: Marshes, bogs, and swamps.
5. tOSlopes greater than 15% or 8.50 �G{ s- e'u
0 6. t,�,vFloodplain
O 7. CA,5eismic Hazard Area
8. ��4quifer Recharge Area
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9. Other
Comments:
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Authorized Signature Date
GARY YANDO,DIRECTOR
s c�ON�crArFp'
M o
A y DEPARTMENT OF COMMUNITY DEVELOPMENT
x
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T Z PLANNING -SOLID WASTE-UTILITIES
N Y Y BLDG. I a 411 N. 5TH ST. * P.O. BOX 578
of 1864 �o SHELTON,WA 98584 • (360)427-9670
DISCLAU*AER/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.
Aeitt I P IW? -a31� - S'v oo// g-
Date (Parcel No. or Legal Description)
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Property owner's signature(Notarized)
(or the County may accept the signature of the owner's authorized,agent upon proper proof of authorization)
12u s se j ( sGc�"
ACKNOWLEDGEMENT CERTIFICATE (INDIVIDUAL)
STATE OF
COUNTY OF
On this day of , m 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
D
(Date)Notary's signature
_
..+ 1 My Commission Expires: Staff Initial:
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