HomeMy WebLinkAbout000912 Original Contract City of Part Angeles
Record##000912
2015-1324686
Page '1 of 1 G,,ait Claatun f.7mred
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NO N 0CLALLAM COONT'V
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WHEN REC`ORDED RETURN TO
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Name Clallant County Road Department PAID AuG5
Address )Lm r '
t ta.r a e t
REASUREF
City,State,Zile ��.<.,.� � � � C� x � D
QUIT CLAIM DEEB
THE:GRANTOR Clallam County„a political subdivision
for and in consideration of Mutual Benefits of clearing title
conveys and quit claims to The City of fort.Angeles
the following described real estate,situated in the County of Clallam State of Washington:
together with all after acquired title of'the grantors(s)therein.
All right title and interest in that portion of land conveyed to Clallam County and recorded on
7/3101925 under Auditor file number 124078 in Volume 116,Page 635 records of Gallant.
County,State of Washington.
Tax Parcel No.No Parcel Number Assigned
,r BOARD OF CLALLAM COUNTY
Date 14 Aaa 2015 COMMISSIONERS
Jim McEntire
Mike Chapman
Bill Pea
S"1`A"rE OF WASHINGTON )
ss,
COUNTY OF CLALLAM )
Oil this 4�day of 2015,before rate„the undersigned„a Notary Public in and for the State of
Washington,duly commissioned and sworn,personally appeared Jim McEntire,Mike Chapman and
Bill.Peach to me known to be the Gallant County Commissioners,of"the corporation that executed the foregoing
instrunxent„and acknowledged the said instrument to be the lice and voluntary act and deed of said corporation,for
the uses and purposes therein mentioned,and on oath stated they are authorized to execute the said instrument and
that the seal affixed is the corporate seal of said corporation,
Witness my haOmkitficia,I,seal hereto affixed the day and year first above written.
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j�l pro ''/Jr/ l
Notary public in and for the State of Washington,
+` residing;at Port Angeles,
Oill law?
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00-011
Department of
Revenue TO
Washington State REAL ESTATE EXCISE TAX AFFIDAVIT This form is your receipt
PLEASE"TYPE OR PRIN I CHAPTER 8? 15 RC\' -CHAPTER 1,,8-6 IA 44':1..0 when stamped by cashier,
THIS AFFIDAVIT WILL NOT BE ACCEPTED UNLESS ALL AREAS ON ALL,PAGES ARE FULLY COMPLETED
El Check box it partial sale of nimer (See back of Bast page for instructions)Ifmull ple owners,list percentage ofowneighm next to name
Name The CAt of Port Anaeles— Name Clallam County Road Department
z Mating Address P.O.BOX 1150 Mailing Address 223 E.4th—Street Suite 6
z
�.4 City/State/Zip Port Anoeles WA 98362-0217 m pe City/Stare/Zip Port Angedga,WA98362
Phone No(including in ea code)___ Phone No (including area code)
MSend all property tax correspondence to[ZISame as Buyet/Giamee Lista
II real and personal property tax parcel account List assessed value(s)numbers-check box if personal property
Name No Parcel Number Assioned
Mailing Address �p I Pqal 171pndpfinn)
(�Rp
Cay/State,`Zm
Phone No(including area code)_-_-.__
Street address ofproperty:
This property is located in Claflarn Corifity
E]Check box If any of the listed parcels are being segregated from another parcel,are part of a boundary line adjusmient or parcels being merged
LegM description of property, (it more space is needed,you may attach a separate sheet to cacti page of the affidavit)
All right title and interest in that portion of land conveyed to Clallam County and recorded on 7/31/1928 under Auditor file number 124078
in Volume 116,Page 635 records of Clallam County,State of Washington.
Select I and Use Code(s): List all personal property(tangible and intangible)included in selling
Select Land Use C.Ires price.
enter any additional codes:
(See back of last page for instructions)
YES NO
Was the setter receiving a property Lax exemption or deferral wider
chapters Xt ,7,orK4 tk(tioiipi-ofiturganiz.atiL)n,seni(n-
citizen,or disabled person,homeowner with limited income)?
M— YES NO If claiming an exemption,list WAC.number and reason For exemption:
Is this property designated as forest land per chapter81 t4�`,? [:] El WAC No.(Section/Subsection) WAC 458-61A-205(2)
Is this property classified as current rise(open space,turni and E-1 E3 Reason for exemption
agricultural,or Umber)land per chapter 8 t �4 H, tic?
Is this property receiving special valuation as historical property M M Government Transfer
Perchapter x '(,k?,i Is?
Ifany answers am yes,complete as;instructed below. 'type ot'Document Quit Claim Deed
(1)NO'FICEOFCONl-ISAJAINCE(FORF91f I-AND Oil 0jRRENNT I!SF)
NEW OWNER(S): o continue the Current designation as forest land or Date ot'Document 8/4/15
classification as current use(open space,farm and agriculture,or further)land,
you must sign on(3)below,The county assessor must then determine ifthe Gross Selling price S 0,00
land transferred continues to quafity and will indicate by signing below.If the *Personal Property(deduct) $
land no longer qualifies or you do not wish to continue the designation or Exemption Claimed(deduct) S
classification,it will be removed and the compensating or additional taxes will
be due and payable by the seller or uranstetor at the time ofsale.(R01, faxable Selling Price $ OrGO
X� �
I lu or ku\1 S I I I I W).Prior to signing(3)below,you may contact I-xcise Tax:State S 0.00
your local courity assessor for more information.
0.0)50 Local 00
This land []does n does not qualify lor continuance. *Delinquent Interest:State
Local S
DEPUTY ASSESSOR DATE
(2)NOTICE OF COMPLIANCE(illgrORI('PROPEitl'YI *Delinquent Penalty S
NFW OWNER(S):To continue special valuation as historic property, Subtotal S 0,00
sign(3)below.If the new owner(s)does not wish to continue,all 'State Technology Fee S_- 5.00
additional tax calculated pursuant to chapter X I If,R( shall be due and —
payable by the seller or transferor at the time of sale. *Affidavit Processing Lee S--- 0.00
(3) OWNER(S)SIGNATURE Total Due S 10.00
PRINT NAME A MINIMUM OF$10.00 IS DUE IN FFE(S)ANIVORTAX
*SEE INSTRUC FIONS
1CF:KFIFYF:NDE VENALTY OF PERJURY THAT THE FOREGOING IS"TRUE AND CORRECT.
Signature of Signature of
Grunter or Grantor's Age gente--
�-75 ;�a L Grantee or Grantee's A
Name(print) Joe Swordmaker Name(print) Joe Swordmaker
Date&city of signing: Port Angeles,WA Date&city of signing: Port Angeles WA
Perjury:Perjury is a class C felony which is punishable by imprisonment in the state correctional institution for a maximum term of not more than five years,or by
a fine in an aniount fixed by the court ci more than five thousand dollars($5,000.00),or by both imprisonment and fine(k(h`I ",", 0 0 rt;g[()),
REV 84 0001 a(04/28115) THIS SPACE-TREASURER'S USE ONLY COUNTY TREASURER