HomeMy WebLinkAboutLot Combination Declaration
Return Address:
City Clerk’s Office
City of Renton
1055 South Grady Way
Renton, WA 98057
Title:
DECLARATION of LOT COMBINATION
Property Tax Parcel Number(s):
Project File #:
LUA____-______-LC
Address or Intersection:
Section _____ Township _____ North Range _____ East, W.M., City of Renton, King County, Washington
Grantor(s): Grantee(s):
1. 1. City of Renton, a Municipal Corporation
I (We), hereby certify that I am (we are)
the owner(s) of the property described in Exhibit ‘A’ on page ____, said property being in common
ownership, do hereby petition the City of Renton to allow the separate parcels to be combined into
single legal lot(s) of record as described in Exhibit ‘B’ on page ____, as specifically allowed by the
Revised Code of Washington, Section 58.17.040 (6). The Map Exhibit on page ____ depicts the
original and the hereby revised parcels.
NOW THEREFORE, in consideration of the mutual benefits to accrue herefrom and by signing hereon,
the parties do for themselves, their heirs and assigns, revise the boundary lines of the parcels
described in the aforementioned Exhibit ‘A’ and establish and recognize the parcel legal
description(s) in the aforementioned Exhibit ‘B’ as the new parcel legal description(s).
IN WITNESS WHEREOF, said Grantor has caused this instrument to be executed
this ______ day of ___________ 20____
City of Renton Approval:
The petition of the property owner(s) to combine the separate properties described in the
aforementioned Exhibit ‘A’ into legal lots of record as described in aforementioned Exhibit ‘B’. This
lot combination is binding upon recordation and the resulting parcel(s) may only be divided through
the City of Renton’s formal subdivision process.
Planning Director Date
City of Renton Department of Community and Economic Development
INDIVIDUAL FORM OF ACKNOWLEDGMENT
Notary Seal must be within box STATE OF WASHINGTON ) SS
COUNTY OF KING ) I certify that I know or have satisfactory evidence that ______________________
___________________________________________ signed this instrument and
acknowledged it to be his/her/their free and voluntary act for the uses and purposes
mentioned in the instrument
Notary Public in and for the State of Washington
Notary (Print)_____________________________________
My appointment expires:____________________________
Dated:
REPRESENTATIVE FORM OF ACKNOWLEDGMENT
Notary Seal must be within box STATE OF WASHINGTON ) SS
COUNTY OF KING ) I certify that I know or have satisfactory evidence that ______________________
___________________________________________ signed this instrument, on oath
stated that he/she/they was/were authorized to execute the instrument and
acknowledged it as the _________________________ and ____________________
of ___________________________ to be the free and voluntary act of such
party/parties for the uses and purposes mentioned in the instrument.
Notary Public in and for the State of Washington
Notary (Print)_____________________________________
My appointment expires:____________________________
Dated:
CORPORATE FORM OF ACKNOWLEDGMENT
Notary Seal must be within box STATE OF WASHINGTON ) SS
COUNTY OF KING ) On this _______ day of _____________, 20____, before me personally appeared
to me known to
be of the corporation that
executed the within instrument, and acknowledge the said instrument to be the free
and voluntary act and deed of said corporation, for the uses and purposes therein
mentioned, and each on oath stated that he/she was authorized to execute said
instrument and that the seal affixed is the corporate seal of said corporation.
Notary Public in and for the State of Washington
Notary (Print)_____________________________________
My appointment expires:____________________________
Dated:
EXHIBIT ‘A’
Original Legal Description
EXHIBIT ‘B’
Revised Legal Description
MAP EXHIBIT
Original Parcel Configuration
Revised Parcel Configuration
