Form 150-310-114 - Application For Property Tax Exemption - Riparian Lands

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ASSESSOR’S USE ONLY
APPLICATION FOR
Date Received
Date Copy Sent to F. & W.
PROPERTY TAX EXEMPTION
Approved by F. & W.
Riparian Lands
Notes
Acres Approved
In Full
ORS 308A.356
In Part
Denied
INSTRUCTIONS:
• File with county assessor by December 31 for assessments beginning the following tax year.
Filed with the _______________________________________ County Assessor for the assessment beginning July 1, 20_____.
Name
Telephone Number
(
)
Street Address
State
ZIP Code
City
1. I request a property tax exemption as RIPARIAN LANDS for the property adjacent to the following stream which borders and/or
flows through my property.
__________________________________________________________
_____________________________
Name of Stream
Stream I.D. Number
2. Property Description (Assessor's Account Number(s) as shown on your tax statement)
______________________________________________________________________________________________
3. The current use of the property adjacent to this stream is:
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
4. A Riparian Management Plan/Agreement for this property has been completed and filed with the Oregon Department of Fish
and Wildlife.
Yes Date filed:____________________________________________________
No
I declare under the penalties of false swearing (ORS 305.990(4)) that I have examined this document, including any attach-
SIGN
ments, and to the best of my knowledge it is true, correct, and complete.
HERE
X
Signature
Date
150-310-114 (Rev. 12-02)

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