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LID Segregation appCITY OF YELM APPLICATION TO SEGREGATE LID ASSESSMENT PLEASE COMPLETE AND RETURN THIS FORM TO: City of Yelm, Community Development Department 105 Yelm Ave. W, P.O. Box 479, Yelm, WA 98597   Property Owner: Mountain Sunrise LLC, Benum Enterprises Mailing Address: P.O. Box 73130 City, St., Zip: Puyallup, WA 98373 Telephone: (253) 845-5555 Current Parcels (Tax Parcel No.) Current Assessment Amount  64301200100 $ 14,585.20  22717330100 $182,315.00     New Parcel Description Number of ERU’s  Mountain Sunrise Lots 1-54 1 ERU per Each Lot  Mountain Sunrise Tract #2 54 ERU’s  (if additional space is required, please attach the requested information on a separate sheet) The undersigned holds an ownership interest in the above referenced parcels(s) located within a local improvement district in the City of Yelm, Thurston County, Washington. The City of Yelm is hereby requested to segregate the assessment amount(s) listed above in accordance with the new property configuration. This application for segregation of assessment is made under the provisions of § 35.44.410 of the Revised Code of Washington. Applicant (please print) Signature Date ASSESSMENT SEGREGATION FEE A segregation fee is due per § 35.44.410 of the Revised Code of Washington as a condition of final map approval. The fee for less than 6 new parcels is $850. For segregation requests resulting in 6 or more new parcels, the fee is $1,000 plus $25 for each parcel over 10 parcels. Please include payment with this completed form. Questions may be directed to Public Finance at (425) 885-1604. CITY USE: RECEIPT # DATE: BY: