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When complete, return application to: City of Redmond Department of Planning & Community Development, MS 4SPL PO Box 97010 Redmond, WA 98073-9710 APPLICATION FOR ISSUANCE OF DEVELOPMENT RIGHTS CERTIFICATE FOR HISTORIC PROPERTIES APPLICATION NUMBER: (staff use only) PROPERTY OWNER: CONTACT PERSON (if different than owner): Name Name Address Address Phone email Phone email 1. Current Name of Historic Property: 2. Historic Name of Property: 3. Check any Register Property is Listed on ( Local) ( Local designated through KC interlocal agreement) ( National) 4. Is this property currently restricted through any preservation easement (check)? Yes No (If so please attach a copy of the recorded easement) 5. King County Parcel Number(s): 6. Legal Description (attach separately) 7. Square Footage of Current Building: 8. Square Footage of Lot: 9. Copy of title report demonstrating current property ownership 10. Name and address of person or company to which this Certificate will be transferred, if different from applicant: ALL TRANSFERS OF DEVELOPMENT RIGHTS SHALL BE BY DEED. NO TRANSFER SHALL BE EFFECTIVE WITHOUT THE PRIOR RECORDATION OF A PRESERVATION EASEMENT RESTRICTING THE ALTERATION OF THE SENDING AREA PROPERTY BY THE OWNERS, FUTURE PURCHASERS, HEIRS, AND ASSIGNS. ALL TRANSACATIONS SHALL BE ON FORMS PRESCRIBED BY THE CITY OF REDMOND. ANY GUARANTEES OF TITLE SHALL BE THE RESPONSIBILITY OF THE GRANTOR. I CERTIFY THAT THE ABOVE INFORMATION IS ACCURATE AND COMPLETE TO THE BEST OF MY KNOWLEDGE: OWNER SIGNATURE APPLICANT (IF DIFFERENT THAN OWNER) PRINT NAME PRINT NAME DATE DATE