Project Rev & CorrespondenceCity of Yelm
Community Development Department
P.O. Box 479
Yelm, WA 98597
(360) 458-3835
(360) 458-3144 FAX
Memorandum
To: SPRC
From: Roberta Allen, Administrative Assistant
Date: October 8, 2002
Re: SPR-02-8325-YL -Project Review Schedule for Yelm Middle School Portables
Attached is the application packet for the above referenced project. After your initial review of
the information submitted, if you need additional information from the applicant, please let me
know as soon as possible. The following is the tentative review schedule for the project.
October 8 -Notice of Application distributed -begin 15 day comment period.
October 23 -SPRC project review. Department comments/conditions of approval for
staff report.
October 31-Letter of Approval completed.
C:\Community Development\Project Files\SPR Site Plan Review\8325 Yelm Middle School Portables\Proj Rev Date Memo.doc
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CITY OF YELM
PO Box 479
Yelm WA 98597
360-458-3835
NOTICE OF APPLICATION
Mailed on: October 8. 2002
PROJECT NAME AND LOCATION: Yelm Community Schools, Portable Classrooms at Yelm Middle
School, 404 Yelm Ave. W., Yelm, WA 98597
LAND USE CASE: SPR-02-8325-YL
An application submitted by Yelm Community Schools, for the above referenced project was received by
the City of Yelm on September 30, 2002. The City has determined the application to be complete on
October 7, 2002. The application and any related documents are available for public review during
normal business hours at the City of Yelm, 105 Yelm Avenue W., Yelm WA. For additional information,
please contact Tami Merriman at (360) 458-3835.
PROJECT DESCRIPTION: Placement of two 28' X 64' portable classrooms at Yelm Middle School,
404 Yelm Ave. W., Yelm, WA 98597.
ENVIRONMENTAL and OTHER DOCUMENTS SUBMITTED WITH THE APPLICATION: The
City of Yelm has determined that the project is categorically exempt from SEPA Environmental review.
Additional Information or Project Studies Requested by the City: No additional information has
been requested at this time.
No preliminary determination of consistency with City development regulations has been made.
At minimum, this project will be subject to the following plans and regulations: City of Yelm
Comprehensive Plan, Zoning Title (17), Critical Areas Ordinance (14.08), Storm Water Drainage Design
and Erosion Control Manual (DOE), Uniform Building Code, State Environmental Policy Act (SEPA) Title
(14), Road Design Standards, Platting and Subdivision Title (16), and the Shoreline Master Program.
The City of Yelm invites your comments early in the review of this proposal. Comments should be
directed to Tami Merriman, Community Development Department, P.O. Box 479, Yelm WA 98597, 360-
458-3835.
THE 15-DAY PUBLIC COMMENT PERIOD ENDS AT 5:00 PM ON OCTOBER 23, 2002
This notice has been provided to appropriate local and state agencies, and property owners within 300
feet of the project site. These recipients, and any others who submit a written request to be placed on the
mailing list, will also receive the following items when available or if applicable: Environmental Threshold
Determination, Notice of Public Hearing and Notice of Final Decision. If the proposed project requires a
City Council decision, it will be mailed to all those who participate in the public hearing and to anyone else
requesting the decision in writing. Additionally, there will be a 14-day public comment period if an
environmental determination is issued. Opportunities for appeal occur within twenty one (21) days after
the date the environmental determination is issued. City Council decision can be appealed through
Superior Court. Appeals of site plan review decisions may be filed within t4 days of Notice of Final
Decision.
G\Community DevelopmenP.Prajec[ Files\SPR Site Plan Revicw\8325 Yelm Middle School Portables\Notice of Applicarion.doc
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°"°'"" '_ _"" ADDITIONS AND`M6DERNIZATION OF THE noxuu w. eooean.,wcmrecr /<~~^+~-;
e"~ `""" ~ ~~ YELM MIDDLE SCWOOL --°- ~ '~~' '~`
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WA i~I1NG TON
CITY OF YELM
PO Box 479
Yelm WA 98597
360-458-3244
APPLICATION FOR
Site Plan Review
OFF IAL USE ONLY
F AU ``
Date''R~ec,~e^ived Y
By J••`
File No. -UL
~3 o'1S
Site Plan Fee:
Mobile Home Parks: $250.00 plus $50.00 per mobile home space
Multi-Family Building/Condominium: $350.00 plus $50.00 per unit
Commercial Site Plan: $350.00 plus $50.00 per 1000 sq. ft of gross floor area
Industrial Site Plan: $350.00 plus $150 per acre
(In addition, any professional service charges per Resolution #358)
Site plan review is a process for reviewing the design of certain types of development. Site plan
approval is required for mobile home parks, duplexes, multi-family dwellings, commercial and industrial
uses, planned development districts and for all land uses within the central business district.
NAME OF PROJECT ycci~~ /~~ r~r~cc' SC~ac~c~t_ - ~,pry~c.C' ~ 19ss ~cwmS
APPLICANT ~r c m ~r~ n~ r>N-r-7' ~ tSCii/OC°~ s
Mailing Address /~z). /.~a-x 5i ~
City, State and Zip ~/C=riyi i~J 9~~~ 97
Telephone 1 ~C C~ y S~- G, /
OWNER /~r3 UV~
Mailing Address
City, State and Zip
Telephone
ENGINEER/ARCHITECT/OTHER Oir/.~>c72 /~ic°%? L ~2c<~Cr /~~/~'/CC/9~y0
Mailing Address /7U , i~~hc c/~'G~
City, State and Zip ~ C- c i» w~ ~'
Telephone ~i~~O - ~/ .Y C.,'/7--~
SUMMARY OF REQUEST ~wsT.~cC_ %n /~~rrFlr3cc' t~CNSS/~DllY~`iS /4i
TNN` i/NZ~it /Jll~yCi= ~SA~nDc ~<z-r~
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PROPERTY DESCRIPTION
General Location 5~C%y ~/rci~~ FJ~~cr. Cr7, ilfuo~ens r9~ v~ ~/ELF /A1/!'~ !~-
l3irlZrlb~-~7U E.JuJx/rt~r $)' ~/.yJ ~SrJ'CtBG-7zCr- ST
Site Address ~~ 1i~zi~l ~/vr- cc~ • Land Area (acres) ?. d f
Section l S' Township /9~/ Range ?. cT'
Assessor's Tax Parcel Number 9s'.~ooEr/ oo~ao
Full legal description of subject property (attach separate sheet if necessary)
~oCri E7r i 7'r~ Ytrt re-r /~ !~ e7r 3
CITY OF YELM PAGE 1
d s\c:bffice\plan de pl. cc\apps\spr. app
PLEASE ANSWER THE FOLLOWING QUESTIONS
ATTACH EXTRA PAGES IF NECESSARY
1. Does the design minimize conflicts with neighboring land uses? Explain. ~~y
F ~ rrx h' ~Sn.,~a,a t_ S~.c rtr
2. Is the site within 300 feet of any "critical areas° such as wetlands or streams? /Jo
3. What provisions will be made for storm water and/or flood control? /Vn
4. What provisions will be made for water supply and sewage disposal? ~/d`S
5. What provisions will be made for electrical power, natural gas, telephone and other utilities? ~C S
6. What provisions will be made for streets, access, and/or buses? C.= xtS rx~tlZ~
7. What provisions, if any, will be made for open space and/or recreation? .tl/q
8. What provisions will be made for schools and school children? /tJ~N
I affirm that all answers, statements and information above and submitted with this application are complete and
accurate to the best of my knowledge. I also affirm that I am the owner of the subject site or am duly authorized
by the owner to act with respect to this application. Further, I grant permission from the owner to any and all
employees and representatives of the City of Yelm and other governmental agencies to enter upon and inspect
said property as reasonably necessary to process this application. I agree to pay all fees of the city which apply
to this application.
r-'
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Signed ~ - ~ Date ~/~F~p2
~ v
CITY OF YELM PAGE 2
d s1c:lofficelpl andept. cc~apps~spr. app
CHECKLIST
PLANNER USE ONLY
Checked by Date
Submitted
ATTACHMENTS:
~' Environmental Checklist (including $150 fee)v
/' Mail labels (8'/2 X 11 sheet) of Owners of Property
within 300 feet (include Assessor's Tax Parcel Numbers and map.)
" Vicinity map (8'/2 X 11) showing nearby property, streets, land uses,
streams and other features.
~'"' Copy of any covenants or restrictions that will apply.
''° Grading plan for cuts and fills over 100 cubic yards.
` Eight copies of Site Plan at a scale not less than one inch
for fifty feet, showing:
v 1. Datum, north arrow, date and scale.
2. The location of all existing and proposed structures,
including, but not limited to, buildings, fences, culverts,
bridges, roads and streets on the subject property.
-' 3. Wells and underground storage tanks, within 200' of
property.
4. The boundaries of the property proposed to be developed.
--5. All proposed and existing buildings and setback lines.
v 6. All areas, if any, to be preserved as buffers or to be
dedicated to a public, private or community use or for open
space under the provisions of this or any other city ordinance,
information regarding percentage of area covered, locations
and general types of landscaping.
~r/p ~ 7. Conceptual Landscape Plan.
r 8. All existing and proposed easements.
~ 9. The locations of all existing and proposed utility structures
and lines. ~ ,cr, rr~tG• Ar s.~a
,~1~,10. A preliminary storm water drainage systems report and
layout for existing and proposed structures.
11. All means of vehicular and pedestrian ingress and egress
at the site and the size and location of driveways, streets,
and roads.
,~12. The location and design of off-street parking areas showing
their size and locations of internal circulation and
parking spaces.
.-13. The location of all loading spaces, including, but not limited to,
truck loading platforms and loading docks.
X14. Location and area, in square feet, of all signs.
X15. Topographic map or maps which delineate contours,
both existing and proposed, at intervals of two feet, and
which locate existing lakes, streams and forested areas,
(or 5 foot if > 5%.)
A reduced size copy of the site plan not larger than 11 "X17".
Tree and Vegetation Preservation Plan, per section 14.16.110.
Design Guidelines Check-list.
Missing
CITY OF YEIM PAGE 3
dslc:bFFicelplandept. cclapps~spr.app
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Pre-Application Meeting
September 18, 2002
~~ 2
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***These comments are preliminary in nature and are not intended to represent final comments and or
requirements for the City of Yelm. Until a complete application is made, the Community Development
Department can only attempt to inform the applicant of general requirements as they appear in the form
presented by the applicant at the time of pre-submission.
Proponent: Yelm Community Schools
Representative: Erling Birkland
Project Proposal: Add 2 portable classrooms to existing Yelm Middle School Site.
Project Location: 404 Yelm Ave. W, Yelm, Yelm Middle School
Zoning and Open Space/Institutional District, Chapter 17.48
Setbacks: Minimum Lot Coverage 70% of site.
Setbacks: Front yard - 15' from R-O-W
Rear Yard - 25' along property boundaries that are adjacent
to residentially zoned properties (west.)
Side yard - 25' along property boundaries that are adjacent
to residentially zoned properties.
Parking: Chapter 17.72. - 1 stall for each ten (10) students of design capacity.
Applicant will need to supply current parking stall count, and total
student capacity count.
~~ ~ ~L~
vNti i Y~
Landscaping: Chapter 17.80, Type I, and IV.
Normally, a Type I landscaping is required whenever anon-residential
activity is proposed adjacent to a residential zone or use. This would have
~~t been required in the 25' setback described above. In this instance, it is
~~~ ~ not. feasible to landscape the perimeter of the site.
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Refuse:
Type II landscaping is to provide a visual separation of uses from streets
and adjoining uses. The Type II landscaping is required adjacent to the
buildings, with a minimum of five-foot planting area.
Type IV landscaping is needed to provide visual relief and shade in
parking areas. All new parking areas resulting from the addition shall be
landscaped.
All refuse areas are required to be fenced or enclosed and screened with
landscaping.
Traffic: The City has adopted a Transportation Facility Charge (TFC) of $750.00
per pm peak trip. The Ordinance provides a default table that the
applicant can use to determine new pm trips generated or if the type of
use is not on the default table the Trip Generation Manual, 5th Edition,
Institute of Transportation Engineers shall be used to determine new pm
peaks hour trips. To determine the projects impact and fee use the
following formula:
Elementary/ / Jr. High School
.02 new trips x per student x $750.00 = $TFC
.02 X 120 = 2.4 X $750.00 = $1,800.00
If the applicant feels the proposed use would not generate the default
number of trips as designated in the TFC Ordinance an analysis prepared
by a Washington State Licensed Engineer can be submitted to the City for
review and consideration.
SEPA: Environmental Checklist will be required if the required additional parking
is 21 or more new stalls.
Application and Process:
Site Plan Review, Chapter 17.84 is an administrative process. Minimum
application requirements are located in Section 17.84.060 and are listed
on the application form. Project review with SEPA can be completed in
approximately 90 days. Without SEPA project review can be completed in
approximately 60 days. Land use approval typically contains conditions of
approval that the applicant must complete prior to receiving a building
permit.
~~, ~~ ~~~~ p CITY OF YELM
~~~ ~'~ PO Box 479
Yelm WA 98597
~`' 360-458-3835
~'ELi'~
wasr-irnacroty
NOTICE OF APPLICATION
Mailed on: October 8. 2002
PROJECT NAME AND LOCATION: Yelm Community Schools, Portable Classrooms at Yelm Middle
School, 404 Yelm Ave. W., Yelm, WA 98597
LAND USE CASE: SPR-02-8325-YL
An application submitted by Yelm Community Schools, for the above referenced project was received by
the City of Yelm on September 30, 2002. The City has determined the application to be complete on
October 7, 2002. The application and any related documents are available for public review during
normal business hours at the City of Yelm, 105 Yelm Avenue W., Yelm WA. For additional information,
please contact Tami Merriman at (360) 458-3835.
PROJECT DESCRIPTION: Placement of two 28' X 64' portable classrooms at Yelm Middle School,
404 Yelm Ave. W., Yelm, WA 98597.
ENVIRONMENTAL and OTHER DOCUMENTS SUBMITTED WITH THE APPLICATION: The
City of Yelm has determined that the project is categorically exempt from SEPA Environmental review.
Additional Information or Project Studies Requested by the City: No additional information has
been requested at this time.
No preliminary determination of consistency with City development regulations has been made.
At minimum, this project will be subject to the following plans and regulations: City of Yelm
Comprehensive Plan, Zoning Title (17), Critical Areas Ordinance (14.08), Storm Water Drainage Design
and Erosion Control Manual (DOE), Uniform Building Code, State Environmental Policy Act (SEPA) Title
(14), Road Design Standards, Platting and Subdivision Title (16), and the Shoreline Master Program.
The City of Yelm invites your comments early in the review of this proposal. Comments should be
directed to Tami Merriman, Community Development Department, P.O. Box 479, Yelm WA 98597, 360-
458-3835.
THE 15-DAY PUBLIC COMMENT PERIOD ENDS AT 5:00 PM ON OCTOBER 23, 2002
This notice has been provided to appropriate local and state agencies, and property owners within 300
feet of the project site. These recipients, and any others who submit a written request to be placed on the
mailing list, will also receive the following items when available or if applicable: Environmental Threshold
Determination, Notice of Public Hearing and Notice of Final Decision. If the proposed project requires a
City Council decision, it will be mailed to all those who participate in the public hearing and to anyone else
requesting the decision in writing. Additionally, there will be a 14-day public comment period if an
environmental determination is issued. Opportunities for appeal occur within twenty one (21) days after
the date the environmental determination is issued. City Council decision can be appealed through
Superior Court. Appeals of site plan review decisions may be filed within 14 days of Notice of Final
Decision.
C:\Community Development\Project Files\SPR Site Plan Review\8325 Yelm Middle School Portables\Notice of Application.doc
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Memorandum
To: SPRC '`
From: Tami Merriman, Planning Technician
Date: September 4, 2002
Re: BLA-02-8324-YL -Project Review Schedule for Ridge Development Boundary Line
Adjustment
Attached is the application packet for the above referenced project. After your initial review of the information
submitted, if you need additional information from the applicant, please let me know as soon as possible. The
following is the tentative review schedule for the project.
September 18 -SPRC project review. Department comments/conditions of approval for staff report.
September 25 -Letter of Approval completed.
C:\Community Development\Project Files`,I3LA Boundary Line Adjustment\SG24 Ridge Dev -Rainier Commons\E3 [.A-Proj Rev Date
Memo.doc
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CITY OF YELM
PO Box 479
Yelm WA 98597
360=458-3244
OFFICIAL USE O~Y
Fee D
DateReceived~25 oZ
By
F(le No.
APPLICATION FOR / ,
BOUNDARY LINE - c~`7 O~
ADJUSTMENT Fee: $100.00 oR .
LARGE LOT SUBDIVISION Fee: $25o.QO, + $10.00 per lot
(In addition, any professional service charges
per Resolution #358)
Boundary Line Adjustment
Large Lot Subdivision
NAME OF PROJECT ~1 .Ia ~ -.~t 6.2 c.c~ M~+~
y6wner of Parcel(s) Purchaser of Parcel(s) Representative
APPLICANT ~ t u r ~--.~ir lt_`.~ .~ L.. L. L .
Mailing Address 5 ~ ~ t=wrin u i5 ~ 2il rJ ~ _
City, State and Zip Ot-Y r--. ~, .A , wA h 43 5c^,c~-.
Telephone ~ ~~~Zl~~i.~- ?~~5
OWNER -SA r--t ~ ~~ A PPu ~,a ~~
Mailing Address
City, State and Zip
Telephone
SURVEYOR c~ . / ~ l ~c:cJ ! r
Mailing Address ~~j .~+ is ~ ~"~ ~! ~ ~'
City, State and Zip / ~ c t~ `/ ~Lc i ,fl ~ S=S.~"~a'~
Telephone 3~~U ~~i - 39y'~'
PRO'rERTY DESCRIFTIGN
General Location t..'''~ ~-~-~~.- c:..ti -5r. ~ 1 t~ ~~' /a~~
Address of Site (if assigned) itvS-,G 1t~ , T~~- A ~: ~..
Area of Project (in acres, if possible) / , '7 '7 fj .~} G-
Area of entire contiguous ownership (if other than above}
Section 7~,~ Township i7,u Range
Assessor's Tax Parcel Number(s) of property included in this application:
C~ ~~ 3v _~ y~!!~_i c~ ~ G> 43c~?.~:i c~ .;~'?i ~f- C~ ~ 3c~ 7 n~d.:~"~rG%
Zoning District L--- 1 Shoreline Designation (f applicable)
Comprehensive Plan/Sub-Area Plan Designation
Type of on-site structures (give lot numbers) I.~or.~1
(SHOW LOCATION AND LABEL EACH STRUCTURE ON MAP)
WHAT USES ARE PROPOSED FOR THE VACANT LOTS? The uses must be consistent with zoning.
Single Family, on Lots Duplex, on Lots
Multifamily, on Lots ~ Commercial, on Lots Ate`.
Industrial, on Lots
IF UNDECIDED, LOTS WILL BE REVIEWED FOR ONE SINGLE-FAMILY RESIDENCE PER LOT.
Existing sewage disposal: _ None _ Septic tank (date installed ) _/Sewer
(SHOW ON MAP)
Proposed sewage disposal: _ None _, Septic tank /Sewer _ Other
Existing water supply: _ None _ Individual well on lot(s) #
(SHOW ON MAP)
_ Community Well -Name of System or Owner
Municipal Water System -Name of Municipality t'° ~--~
RECEIO Ep7 9~tl
AUG2~1002
B3~13~3b
DECLARATION OF BOUNDARY LINE ADJUSTMENT AND COVENANTS
KNOW ALL MEN BY THESE PRESENTS:
That we the undersigned having a real interest in the tract of land described by the declaration;
and do hereby declare the herein described adjustment of land certified as Boundary Line Adjustment
Number , on the day of , 19_, by
the Planning Department, subject to the following covenants and conditions:
1. That all subsequent deeds will contain provisions for private roads in the manner
described herein.
2. That ail maintenance of any private road described by this declaration shall be by the
owners of the parcels having legal access therefrom or their heirs, assigns, or successors, unless and
until such roads are improved to the subdivision standards and dedicated to and accepted by the
appropriate governmental jurisdiction.
3. That any private road will be subject to the further right of the grantor or his successor
and of any telephone, electric, gas, water,~or sewer company, public or private, to lay or cause to be laid
and the right of ingress or egress for the purpose of maintaining telephone, electric, gas, water or sewer
pipes, mains, or conduits across a described portion of such road.
4. That with respect to any private road described by this declaration whether it remains
private or becomes a dedicated road, there is the additional right to make all necessary slopes for cuts
and fills; and the rights to continue to drain said roads and ways over and across any lot or lots where
the water might take a natural course upon reasonable grading pursuant to improvement for dedication
of the roads and ways shown herein. Following reasonable grading pursuant to improvement for
dedication of the roads and ways shown herein, no drainage waters on any lot or lots shall be diverted or
blocked from their natural course so as to discharge upon any public road rights-of-way or to hamper
proper road drainage.
5. That the adjusted legal description of each of the tracts being adjusted is attached
hereto and incorporated by reference as though fully set out herein.
6. That additional covenant, easements, restrictions, if any, solely for the benefd of the
grantor, and his heirs, successors, and assigns enforceable only by such persons, are attached hereto
either as exhibits or as previously recorded under Auditor's File Number
and incorporated by reference as though fully set our herein.
That these covenants are for the mutual benefit of the grantor and his heirs, successors
and assigns and are for the further purpose of compliance with the resolutions and regulations of the
appropriate local governmental Jurisdiction, and the local government and such persons are specifically
given the right to enforce these restrictions and reservations by injunction or other lawful procedure and
to recover any damages resulting from such violation.
DATED this day of ,19_
~1~~`I L•r'~o.~-f~t~ 13rc2~ t ~ 1=~ N~~tif}r::(L
Grantor ~ Grantor
Grantor
Grantor
Grantor
Grantor
STATE OF WASHINGTON )
ss.
COUNTY OF THURSTON )
On this day personally appeared before me '1. w4 ~o t
to me known to be the individual- described in and who executed the within and foregoing instrument,
and acknowledged that ~_ signed the same as ~_ free and voluntary act and deed,
for the uses and purposes therein mentioned.
GIVEN under my hand and official seal this ~_ day of
14_-' ~X~~--
~-5H ..,~---- .~
ALEE K. WEINMANN
NOTARY PUBLIC ~ NO Y PUBLIC an fo the State of
~ STATE OF WASHINGTON i shi ton residing at
~ My Commission Expires Dec. 11, 2005 ~
STATE OF WASHINGTON )
ss.
COUNTY OF THURSTON )
On this day personally appeared before me
to me known to be the individual- described in and who executed the within and foregoing instrument,
and acknowledged that signed the same as free and voluntary act and deed,
for the uses and purposes therein mentioned.
GIVEN under my hand and official seal this day of
19_
NOTARY PUBLIC in and for the State of
Washington residing at
AUDITOR'S CERTIFICATE
File for record at the request of
this day of ,19 , at minutes past o'clock _.m., and
recorded in Volume of Large Lot Subdivisions on page ,records of Thurston
County, Washington.
Thurston County Auditor
By: Deputy
LEGAL DESCRIPTION(S) OF PARCEL(S)
PARCEL A -ORIGINAL
OF LOT 5 OF SHORT SUBDIVISION No. 8167 AS RECORDED UNDER
THURSTON COUNTY AUDITOR'S FILE No. 3041301.
PARCEL A -NEW
THE WEST 152.00 FEET OF LOTS 4 AND 5 OF SHORT SUBDIVISION No.
8167 AS RECORDED UNDER THURSTON COUNTY AUDITOR'S FILE No.
3041301.
CITY OF YELM, COUNTY OF THURSTON, STATE OF WASHINGTON.
PARCEL B -ORIGINAL
OF LOT 4 OF SHORT SUBDIVISION No. 8167 AS RECORDED UNDER
THURSTON COUNTY AUDITOR'S FILE No. 3041301.
PARCEL B -NEW
LOTS 3, 4 AND 5 OF SHORT SUBDIVISION No. 8167 AS RECORDED UNDER
THURSTON COUNTY AUDITOR'S FILE No. 3041301, EXCEPT THE WEST
152.00 FEET OF SAID LOTS 4 AND 5; ALSO EXCEPT THE EAST 60.00 FEET
OF SAID LOT 3.
PARCEL C -ORIGINAL
OF LOT 3 OF SHORT SUBDIVISION No. 8167 AS RECORDED UNDER
THURSTON COUNTY AUDITOR'S FILE No. 3041301.
PARCEL C- NEW
THE EAST 60.00 FEET OF LOT 3 OF SHORT SUBDIVISION No. 8167 AS
RECORDED UNDER THURSTON COUNTY AUDITOR'S FILE No. 3041301.
CITY OF YELM, COUNTY OF THURSTON, STATE OF WASHINGTON.
I hereby certify that the above legal description(s) are accurate and in compliance with
Subdivision Code. Said descriptions (are) (are not) based upon a Recorded Survey.
Submitted this ~~~ day of _~[~~c~~ ~ ,~ ,~
~6~~~ ~ ~ Ste, ~~` ~~,
Name of Title Co. Or Surveyor Signature