Bruno LID SegCITY 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: Dan Bruno, Heritage Homes and Land, Inc.
Mailing Address: P.O. Box 1269
City, St., Zip: Eatonville, WA 98328
Telephone: ( 360 ) 832-8877
Current Parcels
(Tax Parcel No.)
Current Assessment Amount
New Parcel Description
Number
of ERU’s
21725120000
$36,463.00
Hawks Landing
1 ERU
21725120100
$36,463.00
Subdivision
Per Lot
21725111000
$36,463.00
Lots 1 – 60
(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: