Mitigation/shoreland Vegetative Buffer Agreement

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MITIGATION/SHORELAND
VEGETATIVE BUFFER
AGREEMENT
(Document Number)
This agreement is made between the
government unit and the property owner.
Property Owners:
Agreement Date:
Township:
Legal Description
Name & Return Address
PLEASE ATTACH
ZONING
A COPY OF YOUR DEED
to this document
_____-_________-_______
Parcel ID #
I/We ______________________________________________________________________________
being the owner(s) of the above described property , acknowledge that in exchange for a zoning permit,
I/We have agreed to complete the following mitigation/shoreland buffer activity:
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
I/We further acknowledge and agree to the following:
a. A plan describing the project is on file in the Polk County Zoning Department and any
deviations from said plan require approval.
b. This agreement and maintenance of the area is binding on any future owners, heirs, and
assignees of this property and upon sale of the property the buyer will be informed of
this agreement.
I/We have been informed that failure to comply with this agreement will result in enforcement action and
penalties as authorized under the Polk County Shoreland Ordinance.
Owner(s) name(s) - Please Print
Subscribed and sworn to before me on this date:
Notarized Owner(s) Signature(s)
Notary Public
My commission expires
Polk County Land Information Department
11/02/2016

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