HomeMy WebLinkAboutSUB2014-00002 recorded BLA 2 of 2590028 V: 36 P: 450 Pg:2 of 2 SURV
03/18/2015 09:55 AM $144.00 JEFF CO DEPT OF COMM
Jefferson County WA Auditor's Office - Rose Ann Carroll, Auditor
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B OUNIDARY LIhTE ADJUSTMENT
LOCATED IN GOVERNMENT LOT 1 IN SECTION 18 & GOVERNMENT LOT 4,
SECTION 7, TOWNSHIP 29 NORTH, RANGE 1 EAST, W.M.,
JEFFERSON COUNTY, WASHINGTON
LOT OWNER'S ACKNOWLEDGEMENT JEFFERSON COUNTY NOTICE TO PUBLIC
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OF THE LAND DESCRIBED HEREIN, DECLARE(S) THIS BOUNDARY LINE ADJUSTMENT TO
BE CREATED BY MY /OUR OWN FREE WILL AND CONSENT(S) AND APPROVE(S) OF ITS
ENTRY INTO THE LAND RECORDS FOR JEFFERSON COUNTY THROUGH RECORDATION
OF THIS SURVEY WITH THE JEFFERSON COUNTY AUDITOR.
v
KENNETH LAWRENCE MCMILLEN OWNER
AIMEE LORRAINE MCMILLEN OWNER
1 � :.;wA
KE NETH ALLEN MCMILLEN OWNER
TRUSTEE OF THE MCMILLEN FAMILY REVOCABLE LIVING TRUST
YEANNE MARIE MCMILLEN
OWNER
TRUSTEE OF THE MCMILLEN FAMILY REVOCABLE LIVING TRUST
MLA 14 - 00010 /SUB 14 - 00002
1. CURRENT JEFFERSON COUNTY GEOGRAPHIC INFORMATION SYSTEMS (GIS) MAPS
IDENTIFY THE PRESENCE OF AN ENVIRONMENTALLY SENSITIVE ARE4 (ESA) SUCH AS
STREAM, WETLAND, FLOOD, LANDSLIDE HAZARD, EROSION, AQUIFER RECHARGE AREA,
FISH AND WILDLIFE HABITAT, SHORELINE, ETC., LYING WITHIN AND /OR ADJACENT TO
THE REVISED PARCELS ENCOMPASSED BY THIS BOUNDARY LINE ADJUSTMENT. PRIOR
TO ANY LAND DISTURBING, ACTIVITY OR CONSTRUCTION ACTIVITY, APPLICANT /OWNER
SHALL CONTACT JEFFERSON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT
REGARDING COMPLIANCE FOR SUCH ESA'S. APPROVAL OF THIS BOUNDARY LINE
ADJUSTMENT DOES NOT GUARANTEE A BUILDABLE SITE WITHIN SAID PARCEL(S). SUCH
DETERMINATION IS DEPENDENT ON APPROVALS OF WATER, SEPTIC, BULK AND
DIMENSIONAL SETBACKS, AND ESA REQUIREMENT.
2. APPROVAL OF THIS BOUNDARY LINE ADJUSTMENT DOES NOT GUARANTEE A
BUILDABLE SITE WITHIN SAID PARCEL(S). SUCH DETERMINATION IS DEPENDENT ON
APPROVALS OF WATER, SEPTIC, BULK AND DIMENSIONAL SETBACKS, AND ESA
REQUIREMENTS.
JEFFERSON COUNTY APPROVALS
ADMINISTRATOR OF THE DEPARTMENT
OF COMMUNITY DEVELOPMENT
DATE
LIEN HOLDER'S SIGNATURE
DATE
DECLARATION:
KNOW ALL PERSONS BY THESE PRESENTS THAT THE UNDERSIGNED HOLDS A RECORD
INTEREST OR LIEN WITH RESPECT TO THE LAND DESCRIBED HEREIN (PARCEL B), HAS
BEEN MADE AWARE OF AN APPLICATION FOR A BOUNDARY LINE ADJUSTMENT
IMPACTING THE BOUNDARY OF SAID REAL PROPERTY, AND DOES VOLUNTARILY AND
KNOWINGLY CONSENT AND APPROVE OF ITS ENTRY INTO THE LAND RECORDS FOR
JEFFERSON COUNTY RECORDATION OF THIS SURVEY WITH THE JEFFERSON COUNTY
AUDITOR.
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ACKNOWLEDGMENT
STATE O )
COUNTY OF/YI/h -�
THIS IS TO CERTIFY THAT ON THIS DAY OF'_A• 201 BEFORE
ME, THE UNDERSIGNED, A NOTARY PUBLIC IN AND FOR THE STATE OF Pq
DULY COMMISSIONED AND SWORN,' PERSONALLY APPEARED T»�c� —d �a/ �TO
ME KNOWN TO BE THE INDIVIDUAL WHO EXECUTED THE FOREGOING INSTRUMENT AND
ACKNOWLEDGED TO ME THAT HE /SHE SIGNED AND SEALED THE SAME AS HIS /HER
FREE AND VOLUNTARY ACT AND DEED FOR THE USES AND PURPOSES THEREIN
MENTIONED. WITNESS MY HAND AND OFFICIAL S54L THE DAY AND YEAR FIRST ABOVE
WRITTEN.
NOTARY Pludbc IN AND FOR THE STATE
OF 1640
AT
RESIDING A &",Jy
MY APPO'NTMENT EXPIRES f
ATE
Boundar y Adjustment Line oAK
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For: Ken & Aimee McMillen 18 &7(29N -1E'