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 Shadow Investments LLC
Mailing Address: P.O. Box 73130
City, St., Zip: Puyallup, WA 98373
Telephone: (253) 845-5555
Current Parcels
(Tax Parcel No.)
Current Assessment Amount
22718440600
$12,762.05
New Parcel
Description
Number
of ERUs
Mountain Shadow Lots 1-7
1 ERU per lot
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 discounted fee for this application only is $885. Please include
payment with this completed form. Questions may be directed to Public Finance at (425) 885-1604.
CITY USE: RECEIPT # DATE: BY: