HomeMy WebLinkAboutApplication for Land Classification under RCW 84.34 11/70
For Agricultural and Dairy farm operations only.
Exhibit "B"
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FOR ASSES 0 USE� ONL �Y File in Triplicate No. I - Legislative Body
Receive No. 2 - Assessor
Date tliGe.. 3f, (7 7 No. 3 - Applicant
Amount of Fee qla S e. D
Transmitted t.
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Date of Transmittal a-3/-70
APPLICATION FOR LAND CLASSIFICATION UNDER RCW 84.34
OPEN SPACE, AGRICULTURAL OR TIMBER LANDS CURRENT USE ASSESSMENT
Name of Applicant 6=111 , --3e4Ahigii‘
Address (9 04 @ N g ft C LL A'L W4S
Property Location 014,10.) Ctt ,31 j ,/4S/4-
Interest in Property: Fee Owner Contract Purchaser
Other (Describe Interest)
Legal description of land to be classified: (Include map of property showing location on
all improvements)k c r— 7 L ss. /A X'l0..Sec. /tF w /,/ %•.)9>4 A01' W. A, e).6p�e_ a 8 r✓i�o�2 fv, (,
S/3 f.Le- 04 % o ;�r� C�e �k .4Io. % Ae. SCUT , Vq-ir- q A/T. J wwm A% /
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This application may cover more than one parcel, and/or land on which appurtenances neces-
sary to the production, preparation or sale of the agricultural products exist in conjunc-
tion with the lands producing such products and/or parcels of one to five acres, which are
not contiguous but which otherwise constitute an integral part of the farming operation.
Lands with current use of (1) open space, (2) farm and agricultural, or (3) timber land
may be listed on the same application but a legal description must be shown for each
classification. /
Total acres in classification request /-S S-�T' 4 _
Is the land subject to lease or option or other agreement which permits any other use than
its present use? Yes No (Attach copy of lease or option or other agreement)
Describe completely the current use of each parcel of land in classification request
,A06-,cy g�en s- eP y S:/v
Describe�' all present improvements (Buildings,// etc. )
T//��>a!'t' S , Z/,Nc if'.�. it),e /14 gw o e S tf e c( / MP c N r'/Y e
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If application is made for farm and agricultural classification, check which of tie follow-
ing categories apply:
A. Farm and agricultural lands of twenty (20) or more acres.
B. Farm and agricultural lands of five (5) or more acres but less than twenty (20)
acres.
Lands which are in category B must have produced a gross income of $100 or more
per acre per year for three of the last five calendar years. Attach documenta-
tion showing the land has achieved this production level.
C. Farm and agricultural lands of less than five (5) acres.
Lands which are in category C must have produced a gross income of $1,000 or more
per year for three of the last five calendar years. Attach documentation showing
the land has achieved this production level.
I declare under the penalties for perjury that this application and any attached
documents have been examined by me, and to the best of my knowledge constitute a true,
correct, and complete statement. I hereby agree to furnish such additional information
as may be required by the Legislative Body concerning the current use of the land to be
classified.
Owner(s) or Contract Purchas r(s)
Subscribed and sworn to
before m this .:/
day of ! 19 %C� �s >27
/r.
C�
Notary Public in nd r 596
the State of
Residing atL
FOR GRANTING AUTHORITY USE ONLY
Date Received By
Amount of Application Fee
Application for Classification:
Approved ; Approved in Part ; Denied
Owner Notified of Denial on
Agreement Executed and Mailed to Owner on
Land Areas Approved for Classification:
Conditions Imposed:
Signed Agreement Received from Property Owner on
Agreement Transmitted to Assessor on
Signature of Granting Authority
-2-
Department of Revenue PTF 80
DISTRIBUTION
State General _____$_ GENERAL RECEIPT N• 7717
State School
OFFICE OF
State Pk. Pkways.
JEFFERSON COUNTY TREASURER
St. School Equal.
PORT TOWNSEND, WAS
St. Hy. Safety _
State Game
State Fisheries
Motor Vehicle
,
RECEIVE
Driver Education _____
7 04
v C-2.e.coi
Current Expense
-
DOLLARS
S. D. No. Gen.
FOR______
Institute ____
Law Library
City of P. T.
Port of P. T. _
P.U.D. No. 1
Deed Fee
Equipment Rental
_ $_ —
T. B. Hospital Cash
TREASURER OF JEFFERSON COUNTY
Excise Tax ___ Check $
M.J. of P. Clearing
iiDraft ______
SY
—
—
TOTAL $ ),
Cq-- Receipt Waant $$
rr DEPUTY TREASURER
3,000-6/68—Leader Co.
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